Table of Contents
Type: Coursework | Subject: Health and Social Care | Level: Undergraduate | Word Count: ~2,400 words
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Overview: This coursework examines how the Care Act 2014 placed adult safeguarding on a statutory footing in England. It explains the Section 42 three-part test, the six safeguarding principles and the Making Safeguarding Personal approach, then applies the framework to an illustrative case and considers the tensions between protecting an adult and respecting their autonomy.
Safeguarding adults at risk is a central responsibility of everyone working across the health and social care sector in England. The Care Act 2014 marked a significant turning point by placing adult safeguarding on a statutory footing for the first time, replacing the fragmented, guidance-led arrangements that had operated under No Secrets (Department of Health, 2000). This coursework examines how the Care Act 2014 and its accompanying statutory guidance define, structure and support the safeguarding of adults at risk. It considers the legal duties the Act creates, the six principles that underpin good practice, the model of Making Safeguarding Personal, and the categories of abuse that practitioners must be able to recognise. The discussion also explores multi-agency working and the practical tensions that arise when the duty to protect meets the equally important duty to respect an adult’s autonomy. Throughout, the aim is to demonstrate how legislation translates into person-centred practice rather than simply to describe the law in the abstract.
Safeguarding can be understood as the range of activity designed to protect an adult’s right to live in safety, free from abuse and neglect, while also promoting their wellbeing (Department of Health and Social Care, 2023). It is not a single event but an ongoing process that balances protection with the promotion of independence, choice and control. A key conceptual shift introduced by the Care Act 2014 was the move away from the language of the “vulnerable adult” towards the idea of the “adult at risk”. The earlier terminology was criticised for locating vulnerability within the individual, implying that some people are inherently weak, when in reality risk often arises from a person’s circumstances and from the behaviour of others (Mandelstam, 2017).
Under the Act, safeguarding duties are triggered in relation to an adult who meets a three-part test. The local authority must have reasonable cause to suspect that the adult: has needs for care and support (whether or not the authority is currently meeting those needs); is experiencing, or is at risk of, abuse or neglect; and, as a result of those care and support needs, is unable to protect themselves against the abuse or neglect or the risk of it (Care Act 2014, s.42). All three limbs must be present for the statutory safeguarding duty to apply. This framing is important because it focuses attention not on a label but on the relationship between a person’s needs, the harm they face and their capacity to secure their own protection.
The Care Act 2014 situates safeguarding within a broader statutory architecture rather than treating it as a stand-alone function. Section 1 of the Act establishes an overarching wellbeing principle, requiring local authorities to promote the individual wellbeing of each adult when exercising their functions. Wellbeing is defined broadly to include personal dignity, physical and mental health, protection from abuse and neglect, control over day-to-day life, and social and economic wellbeing (Care Act 2014, s.1). Safeguarding is therefore not separate from wellbeing; it is one of its components.
The core safeguarding duty is contained in Section 42, which obliges a local authority to make enquiries, or to cause others to make enquiries, where it has reasonable cause to suspect that an adult meeting the three-part test is at risk. The purpose of the enquiry is to decide whether any action should be taken and, if so, by whom (Department of Health and Social Care, 2023). Section 43 requires every local authority to establish a Safeguarding Adults Board (SAB), while Section 44 places a duty on the SAB to arrange a Safeguarding Adults Review (SAR) in specified circumstances. Section 45 imposes a duty on partner organisations to supply information to the SAB, supporting the cooperation on which effective safeguarding depends.
The Act does not operate in isolation. It must be read alongside the Mental Capacity Act 2005, which governs decision-making for adults who may lack capacity, and the Human Rights Act 1998, under which public bodies must act compatibly with Convention rights such as the right to life (Article 2), freedom from inhuman or degrading treatment (Article 3) and respect for private and family life (Article 8). Together these statutes create a legal framework in which protection, capacity and human rights are considered as one (Johns, 2020).
The statutory guidance sets out six principles that should inform all safeguarding work (Department of Health and Social Care, 2023). These principles, summarised in the table below, originated in earlier government policy and have become the common language of adult safeguarding across England.
| Principle | What It Means for Safeguarding Practice |
|---|---|
| Empowerment | Supporting people to make their own decisions through informed consent, with the adult leading the process wherever possible. |
| Prevention | Acting before harm occurs by raising awareness and responding early to concerns. |
| Proportionality | Responding in the least intrusive manner appropriate to the risk presented. |
| Protection | Providing support and representation for those in greatest need. |
| Partnership | Working together across communities and agencies to prevent, detect and report abuse. |
| Accountability | Ensuring transparency and clear responsibility in the delivery of safeguarding. |
The principles are not a checklist to be completed in sequence but a set of values that must be weighed together. Empowerment and proportionality, for instance, require practitioners to involve the adult and to intervene no more than is necessary, while protection and accountability ensure that those in greatest need still receive a timely and defensible response (Local Government Association and Association of Directors of Adult Social Services, 2019).
The six principles find practical expression in the approach known as Making Safeguarding Personal (MSP). Developed by the Local Government Association and the Association of Directors of Adult Social Services, MSP reframes safeguarding as something done with people rather than to them (Local Government Association and Association of Directors of Adult Social Services, 2019). Historically, safeguarding processes were often procedure-driven and risk-averse, measuring success by the number of enquiries completed rather than by whether the adult’s life had actually improved. MSP instead asks the person at the outset what outcomes they want to achieve and keeps those outcomes at the centre of every decision.
In practice, this means that a practitioner responding to a concern will explore what the adult wants to happen, what a good outcome would look like for them, and how much risk they are willing to accept. For one person the desired outcome might be that the abuse stops while an important relationship continues; for another it might be a complete separation from the person causing harm. By recording outcomes at the start and reviewing them at the end, services can measure whether the adult feels safer and more in control (Department of Health and Social Care, 2023). MSP therefore embodies the principle of empowerment, reinforcing that an adult with capacity has the right to make decisions about their own life, including decisions that others might consider unwise.
Effective safeguarding depends on the ability of practitioners to recognise abuse in its many forms. The statutory guidance identifies ten categories of abuse and neglect, although it stresses that this list is not exhaustive and that local circumstances may give rise to other forms of harm (Social Care Institute for Excellence, 2020). The recognised categories are:
The inclusion of self-neglect as a category reflects a growing recognition that serious harm can arise without any third party being responsible, for example through hoarding, refusal of essential care or neglect of one’s own health (Braye, Orr and Preston-Shoot, 2011). Recognising abuse is rarely straightforward: indicators such as unexplained injuries, a sudden change in financial circumstances, withdrawal or fearfulness may each have innocent explanations. Practitioners are therefore encouraged to remain professionally curious, to consider patterns rather than isolated signs, and to share proportionate concerns rather than waiting for certainty before acting.
No single organisation can safeguard adults effectively on its own, and the Care Act 2014 reflects this through its emphasis on partnership. The local authority holds lead responsibility for coordinating safeguarding arrangements in its area, but it discharges this role in concert with a wide network of partners (Care Act 2014, s.43). Each Safeguarding Adults Board must include, as a minimum, the local authority, the relevant NHS body and the chief officer of police, and it typically draws in further members such as housing providers, care providers, probation services and the voluntary sector.
The SAB has three core statutory objectives: to develop a shared strategy, to coordinate the work of its members and to hold partners to account for the effectiveness of local safeguarding. One of its most important functions is to commission Safeguarding Adults Reviews under Section 44. A SAR must be arranged where an adult with care and support needs has died or experienced serious harm, abuse or neglect is known or suspected, and there is concern about how agencies worked together (Department of Health and Social Care, 2023). The purpose of a review is not to apportion blame but to identify learning that can improve future practice. Reviews repeatedly highlight the same themes: poor information-sharing, professionals working in silos, and a failure to see the whole person behind separate referrals (Preston-Shoot, 2020). Front-line staff across all agencies share a duty to recognise concerns, to report them promptly and to cooperate fully with enquiries.
The value of the legislative framework becomes clearest when it is applied to a concrete situation. Consider the following illustrative scenario, in which the names and details are entirely fictional and are used only to demonstrate how the law operates. Mrs A, an eighty-year-old woman with early-stage dementia, lives at home with support from a domiciliary care agency. A care worker notices that Mrs A has become withdrawn, that money is frequently missing from her purse, and that her adult grandson, who has recently moved in, controls access to her bank card.
Applying the Section 42 test, the local authority would consider whether Mrs A has care and support needs (she does), whether she is experiencing or at risk of abuse (there are indicators of financial and possibly psychological abuse), and whether her needs mean she cannot protect herself (her dementia may affect her ability to manage the situation). If all three limbs are met, the authority has a duty to make enquiries. Consistent with the Mental Capacity Act 2005, practitioners would assess Mrs A’s capacity to make specific decisions about her finances and living arrangements, presuming capacity unless an assessment shows otherwise and supporting her to participate as fully as possible. Guided by Making Safeguarding Personal, they would ask Mrs A what outcome she wants, which might be that the financial abuse stops while her relationship with her family is preserved. The response would then be proportionate, involving the police only if she wished to pursue that route, and would respect her Article 8 right to family life while still protecting her from harm.
Safeguarding practice is characterised by tensions that the legislation frames but cannot fully resolve. The most persistent is the tension between protection and autonomy. An adult with capacity is entitled to make decisions that others regard as risky or unwise, and professionals must resist the temptation to override that choice in the name of safety (Johns, 2020). The principle of proportionality demands that any intervention be the least restrictive consistent with managing the risk, yet defensive, risk-averse practice can lead to over-intervention that itself undermines wellbeing.
Mental capacity sits at the heart of these dilemmas. Where an adult may lack capacity, the Mental Capacity Act 2005 requires a decision-specific assessment and, where capacity is absent, a best-interests decision that remains as unrestrictive as possible. The interface between the Care Act and the deprivation of liberty regime has proved particularly complex; the Liberty Protection Safeguards were intended to replace the Deprivation of Liberty Safeguards, but their implementation has been repeatedly delayed, leaving practitioners to continue working within the older framework. Self-neglect poses a further challenge, requiring services to balance respect for an adult’s lifestyle choices against the risk of serious harm (Braye, Orr and Preston-Shoot, 2011). Finally, these professional judgements are made against a backdrop of rising demand and constrained resources, which can place pressure on the timeliness and depth of enquiries. Good safeguarding therefore depends not only on sound law but on skilled, reflective practitioners who can hold competing duties in balance.
The Care Act 2014 transformed adult safeguarding in England from a patchwork of guidance into a coherent statutory duty grounded in wellbeing. By defining the adult at risk through the Section 42 three-part test, establishing Safeguarding Adults Boards and Safeguarding Adults Reviews, and embedding the six principles and Making Safeguarding Personal, the Act provides both a legal mandate and a value base for practice. Yet this coursework has shown that legislation alone cannot safeguard anyone. Its effectiveness depends on practitioners who can recognise the many forms of abuse, work confidently across organisational boundaries, apply the Mental Capacity Act and the Human Rights Act alongside the Care Act, and, above all, keep the individual’s own outcomes at the centre of the process. The enduring challenge is to protect adults at risk while respecting their autonomy, dignity and right to make their own choices. Meeting that challenge requires continual learning, reflective judgement and a genuine partnership between services and the people they support.
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