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Stage Two: Making a Referral

This chapter was added to the manual in April 2015.


  Action of Adult Social Care on Receiving a Referral
  Assessment of Risk and Urgency
  Concerns Relating to a Person Living or Receiving Services in another Local Authority Area
  Medical Assessment
  Consultation with the Police
  Where there is a Need for Immediate Action Following Referral
  Feedback to Referrer
  Next Steps

Action of Adult Social Care on Receiving a Referral

Upon receiving a Referral, Adult Social Care must gather as much information as possible from the referrer, multi-agency partners, the adult concerned and previous records, to:

  • Make an initial risk assessment of the situation and risk for the adult about whom the Referral has been made and any other adults who may be at risk;
  • Ensure that the adult concerned is safe, that they have received medical attention if required and that the emergency services have been involved appropriately;
  • Assess if a criminal offence may have been committed and if there is a need to preserve evidence and to advise the referrer accordingly;
  • Ascertain the views of the adult concerned, e.g. do they wish to report the matter to the police, what outcome do they want;
  • Begin an assessment of the mental Capacity of the adult concerned to make decisions about what should happen to them;
  • Ensure management discussion and sign-off is recorded at key decision making points.

Assessment of Risk and Urgency

On receipt of a Referral, Adult Social Care should make direct contact with the Adult in order to make an informed judgment regarding safety and the urgency for intervention.

A decision will be made in consultation with the line manager and recorded/signed and dated, on the level of urgency required to pursue the next stage of the procedures. The assessment of urgency includes the presenting level of risk to the adult and any other adults who may be at risk and incorporates:

  • The need for urgent medical assessment;
  • The level of threat to independence;
  • The impact of the alleged Abuse on the physical, emotional and psychological wellbeing of the adult;
  • The duration and frequency of the alleged Abuse;
  • The degree and extent of the alleged Abuse;
  • The level of personal support needed by the adult, and whether that support is normally provided by the alleged perpetrator;
  • The extent of premeditation, threat or coercion;
  • The potential for further Abuse;
  • The context in which the alleged Abuse takes place.

Whether there is any need for any action in respect of other adults who may be at risk, such as any other adult living in the same household or having contact with an alleged perpetrator.

Account will be taken of the fact that whilst a single event may create a serious risk to the person's wellbeing, it is often the accumulation of events - each of which may appear small - that causes serious harm.

Concerns Relating to a Person Living or Receiving Services in another Local Authority Area

When the concerns relate to a person who lives or receives services in another local authority area but is temporarily in Lancashire, Cumbria, Blackburn with Darwen or Blackpool, the Adult Social Care offices in the local authority where the adult ordinarily lives and where the alleged abuse occurred or suspicion arose must be informed.

The authority where the alleged Abuse occurs or suspicion arose will usually have overall responsibility for coordinating safeguarding arrangements, but this should be the subject of an agreement between the two local authorities involved.

Where necessary, the Safeguarding Adults TeamĀ (see Local Contacts) should be contacted for advice.

See also Out of Area Safeguarding Arrangements Protocol for Inter-Authority Safeguarding Adults Investigation and Protection Arrangements (ADASS 2012).

Medical Assessment

In cases where the referral is of suspected Abuse and Neglect, a decision will be made with the line manager (and reasons recorded) whether a medical assessment is required.

Medical assessment must be considered in cases of suspected:

  • Serious or unexplained injury;
  • Sexual Abuse or assault;
  • Serious neglect.

Cases of suspected Sexual Assault and serious physical injury should also be reported immediately to the police.

If a medical assessment is advised, the adult should be assisted in arranging and attending as necessary. The reasons for the proposed assessment should be fully explained to the adult or to the carer and/or advocate if the adult appears incapacitated in this respect.

Effective Outcomes: Making Safeguarding Personal Procedure.

Consultation with the Police

In all cases where an offence may have been committed but has not been reported, there will be prompt consultation with the police who will determine if they need to be involved.

A decision will be made by the police as soon as possible as to whether an Achieving Best Evidence interview is necessary. If so it should be carried out as soon as practicable.

Where there is a Need for Immediate Action Following Referral

Where it is identified by Adult Social Care that immediate action is needed to protect the safety of one or more adults, information will be passed to the appropriate person in the organisation best able to implement those safeguards as soon as possible.

This will happen on the same day that the referral is received.


Feedback to Referrer

If the referrer has not received an acknowledgement within 3 working days, he/she should contact the manager in the Adult Social Care/Safeguarding team again. If unsatisfied with the response, the referrer should discuss the matter with their own manager.

This applies to anyone making a Referral, whether internally or from an external agency.

Feedback on the outcome of a referral should be provided to the referrer, including where no further action is to be taken.

In the case of a Referral by a member of the public, feedback should be provided in a way which will respect the confidentiality of the Adult at Risk.

Next Steps

After undertaking the actions detailed above following receipt of a Referral, a manager from the Local Authority will determine whether the reported injury or concern should be treated as an adult safeguarding issue. This action will be taken within one working day of the receipt of the Referral.

Please refer to the Decision Stage following a Referral.