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Your responsibilities
Abuse and neglect
Safeguarding principles
Your role as alerter
Multi-Agency Working
Information Sharing
The Mental Capacity Act
Deprivation of Liberty
PREVENT
V1.0, October 2013
Guidance and resources
Your responsibilities
Safeguarding adults
Vulnerability in adults
All staff working within the NHS
have a responsibility for the safety
and wellbeing of the people who
use our services. Living a life that is
free from harm and abuse is a
fundamental human right of every
person and is an essential
requirement for health and
well-being.
An ‘adult at risk’ is someone who is
over 18, who has care or support
needs, and who is unable to take
steps to protect themselves from
abuse or neglect by others.
Safeguarding adults is about
protecting the safety and
well-being of all patients, but
particularly those who are least
able to protect themselves from
the risk of abuse or neglect.
People with care and support needs
can sometimes live in vulnerable
circumstances and may be at
increased risk of abuse or neglect
by others. We all have a
responsibility work together to spot
those at highest risk and to take
steps to protect them. It is part of
our duty of care.
Safeguarding is fundamental
to the outcomes expected of the
NHS and is integral to compliance
with legislation, regulations and
quality standards. Safeguarding is
not an ‘add-on’ to what we do,
but should inform our day to day
practice at all times.
At certain times in our lives, and in
certain circumstances, anyone can
become vulnerable to the risk of
abuse from others. But for some
people the risk of harm can be
more pronounced and enduring, for
example people who have a
learning disability, a mental health
problem, or who are physically frail
or disabled.
Dignity in Care
Dignity underpins the whole
concept of adult safeguarding. If
we lose sight of the fundamental
right of all adults to be treated with
dignity and respect - especially the
most vulnerable members of our
society - then we create a climate in
which the risk of abuse and neglect
rises. The Dignity in Care campaign
has set a 10 point dignity challenge
to anyone working in health or
social care. Any practitioner and
any service can measure their
performance in these 10 key areas.
Your responsibilities
The Dignity Challenge
Duty of Care
1. Have a zero tolerance of all
forms of abuse
4. Enable people to maintain the
maximum possible level of
independence, choice and control
Every NHS funded organisation and
every healthcare professional has a
duty to ensure that people in
vulnerable circumstances are kept
safe and receive the highest
possible standards of care.
However, protecting adults from the
risk of harm does not mean taking
over control of their lives. All adults
have the right to make their own
choices and decisions in life, and
sometimes adults can make
choices which leave professionals
feeling uncomfortable.
5. Listen and support people to
express their needs and wants
Safeguarding does not always
have easy answers.
6. Respect people's right to privacy
Duty of care means ensuring that
all reasonable and proportionate
steps have been taken to assess
risk and to support the person in
making their own choice. Being
accountable means you must be
able to show how and why you
acted in the way you did. When
acting in a person’s best interests
you must always do so with their
consent unless you believe the
person lacks capacity to make the
decision for themselves. Carefully
assessing mental capacity and
working in line with the Mental
Capacity Act 2005 is therefore a
key factor in adult safeguarding.
2. Support people with the same
respect you would want for yourself
or a member of your family
3. Treat each person as an
individual by offering a personalised
service
7. Ensure people feel able to
complain without fear of retribution
8. Engage with family members and
carers as care partners
9. Assist people to maintain
confidence and positive self-esteem
10. Act to alleviate people's
loneliness and isolation
You can find more information
about Dignity in Care and Dignity
Champions at:
http://www.dignityincare.org.uk/
Abuse and neglect
What is abuse?
‘No Secrets’ is a guidance
document produced by the
Department of Health. It lays out
expectations about multi-agency
working to protect adults at risk
from abuse. It defines abuse as
follows:
‘Abuse is a violation of an
individual’s human and civil
rights by any other person or
persons. Abuse may consist of
single or repeated acts. It may
be physical, verbal or
psychological, it may be an act of
neglect or an omission to act, or
it may occur when a vulnerable
person is persuaded to enter into
a financial or sexual transaction
to which he or she has not
consented, or cannot consent.
Abuse can occur in any
relationship and may result in
significant harm, or exploitation
of, the person subjected to it.”
Abuse may be perpetrated by
anyone who has power or control
over another individual. The person
responsible for the abuse is very
often well known to the person
being abused.
The abuser could be a spouse;
partner; son; daughter; relative;
friend; carer or neighbour; a paid
carer or volunteer; a health worker;
a social care worker; another
resident or service user; a visitor or
someone who is providing a
service.
Abuse may be perpetrated by an
individual deliberately intending to
harm, but equally it can occur when
someone fails to take the right
action, or unintentionally causes
harm through ignorance.
Categories of abuse
There are many different types of
abuse which adults at risk may be
subject to:
Physical abuse
Such as rough handling,
unreasonable restraint, hitting,
burning, pushing or kicking
someone, locking someone in a
room.
Sexual abuse
Such as inappropriate touching or
forcing someone to take part in or
witness any sexual act against their
will.
Psychological/Emotional abuse
Such as intimidation, bullying,
shouting, swearing, taunting,
threatening or humiliating someone.
Abuse and neglect
Financial abuse
Such as theft, fraud, coercion over
wills, misusing someone’s money,
property or other belongings without
their agreement.
Neglect
Such as not providing necessary
food, heating, care or medicine.
Discrimination
Such as ill-treatment or harassment
based on a person’s age, sex,
sexuality, disability, religious beliefs
or ethnic group.
Institutional
Such as rigid regimes, systemic
poor care, poor organisational
culture, lack of resources, denial of
choice, lack of dignity and respect
for patients.
Abuse can take place anywhere: in
a person’s own home, in day or
residential centres, in supported
housing, educational
establishments, nursing homes,
clinics and hospitals.
Intent is not necessarily an issue in
deciding whether or not an act (or a
failure to act) is considered to be
abusive; it is the impact of the act
on the person and the harm, or risk
of harm, to that individual which is
the key factor.
Consideration must always be
given not only to the immediate
impact on the individual concerned,
but also to the risk of future,
longer-term harm – including
potential harm to others.
Serious harm
Self-Neglect is not classed as a
safeguarding issue within
Birmingham’s local guidance but it
may still be a potentially serious
matter to be addressed through
other routes.
Domestic Violence is a similarly
serious issue but one which is not
normally addressed via the
safeguarding route, unless the
victim is classed as a ‘vulnerable
adult’ or ‘adult at risk’
Serious harm should be taken to
include not only ill-treatment but
also the impairment of, or an
avoidable deterioration in, physical
or mental health; and the
impairment of physical, intellectual,
emotional, social or behavioural
development.
Safeguarding principles
Six Safeguarding Principles
The Department of Health gives us
six key principles which are
expected to underpin our approach
to safeguarding adults:
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Empowerment
Prevention
Proportionality
Protection
Partnership
Accountability
We should continually be checking
whether we are acting in line with
these six principles in the course of
our individual safeguarding
practice. Organisations should also
audit themselves against the six
principles. Some outcomes for
organisations that apply the six
principles effectively could be:
Empowerment
We give individuals the right
information about how to recognise
abuse and what they can do to
keep themselves safe. We give
them clear and simple information
about how to report abuse and
crime and what support we can
offer. We consult them before we
take any action. When someone
lacks capacity to make a decision,
we always act in his or her best
interests.
Prevention
We help the community to identify
and report signs of abuse and
suspected criminal offences. We
train staff how to recognise signs of
abuse and neglect and to take
action to prevent abuse occurring.
In all our work, we consider how to
make communities safer.
Proportionality
We discuss with the individual and
with partner agencies what to do
where there is risk of significant
harm, before we take a decision.
Risk is an element of many
situations and should be part of any
wider assessment.
Protection
We have effective ways of
assessing and managing risk. Our
local complaints and reporting
arrangements for abuse and
suspected criminal offences work
well. Local people understand
how we work and how to contact
us. We take responsibility for
putting them in touch with the
right person.
Partnership
We are good at sharing information
locally. We have multi-agency
partnership arrangements in place
and staff understand how to use
these.
Safeguarding principles
We foster a one team approach that
places the welfare of individuals
before the needs of the system.
Accountability
The roles of all agencies are clear,
together with the lines of
accountability. Staff understand
what is expected of them and
others. Agencies recognise their
responsibilities to each other, act
upon them and accept collective
responsibility for safeguarding
arrangements.
“The people I wanted were
involved”
“I had good quality care - I felt
safe and in control”
“When things started to go
wrong, people around me
noticed and acted early”
“People worked together and
helped when I was harmed”
“People noticed and acted”
The outcomes for individuals
If we apply the six principles
correctly then adults at risk are
likely to get better individual
outcomes from safeguarding, as
opposed to safeguarding being
simply a process that is done ‘to
them’. Some effective outcomes for
individuals might then be:
“I had the information I needed;
in the way that I needed it”
“Professionals helped me to plan
ahead and manage the risks that
were important to me”
“People and services understood
me - recognised and respected
what I could do and what I
needed help with”
“People asked what I wanted to
happen and worked together with
me to get it”
“I got the help I needed by those
in the best placed to give it”
“The help I received made my
situation better”
“People will learn from my
experience and use it to help
others”
“I understood the reasons when
decisions were made that I didn’t
agree with”
Your role as alerter
How to make an alert
Working with patients
If you believe that an adult is at risk
of being seriously abused or
neglected in some way, you should
make a safeguarding alert. Your
concern may result from something
that you have seen, been told, or
heard.
Safeguarding is about
empowerment as well as protection.
When considering whether to make
an alert, always involve the patient
as much as they want and feel able
to. There can sometimes be difficult
and sensitive issues involved, and
there may be challenges around
capacity, communication and
access to the adult who is at risk.
But unless there is very good
reason not to, talk to the patient
about why you feel you may need
to raise a safeguarding alert.
In Birmingham anyone who
wants to make a safeguarding
alert should contact the Adults
and Communities Access Point
(ACAP) on 0121 303 1234.
ACAP will take details of your
concerns and will co-ordinate the
safeguarding response. The
response may involve several
agencies working together. Anyone
can contact ACAP to make an alert,
including members of the public. If
you are a professional, you should
also confirm your concerns in
writing by completing a multiagency
alert form and faxing it to ACAP on
0121 303 6245.
Out of hours you should contact the
Emergency Duty Team on 0121 675
4806
If you think that a crime has been
committed inform the police directly.
West Midlands Police can be
contacted on 0345 113 5000.
Always speak to the patient in a
private and safe place to discuss
your concerns. It is essential to
ensure that the person alleged to
have caused harm is not present
during this process. The patient
may be frightened and fearful of
repercussions. Explain how the
safeguarding process can help
them and how confidentiality is
managed.
Sometimes people can still be
reluctant to take things forward. In
family settings in particular, the
dynamics can be very complex. Be
sensitive to this, but there may be
occasions where you have to make
clear that you have a professional
duty to act.
Your role as alerter
Should I make an alert?
Each situation is different. You have
to assess the situation, consider the
circumstances and decide whether
or not making a safeguarding alert
is the most appropriate and
proportionate response to the
situation. Think about whether your
actions are in accordance with the 6
principles. Consider Birmingham’s
local guidance at www.bsab.org.uk.
Take advice from your safeguarding
lead and act in line with your
organisation’s policy and
procedure. Record your actions and
be accountable for what you did
and why you did it. Remember: if
in doubt, make the alert.
Some factors to consider
How vulnerable is the adult at risk?
What personal, environmental and
social factors contribute to this?
What is the nature and extent of the
abuse?
Is the abuse or neglect a crime or a
potential crime?
How long has it been happening? Is
it a one-off incident or a pattern of
repeated actions?
What impact is this having on the
individual? What physical and/or
psychological harm is being
caused? What are the immediate
and likely longer-term effects of the
abuse on their independence and
wellbeing?
What impact is the abuse having on
others?
What is the risk of repeated or
increasingly serious acts by the
person causing the harm?
Is a child (under 18 years) at risk?
Does the patient have capacity to
make decisions about their safety
for themselves? Remember that
capacity can be undermined by the
experience of abuse or in situations
where the person is being
exploited, coerced, groomed or
subjected to undue influence or
duress.
If the person does not have
capacity, does action need to be
taken in their best interests under
the Mental Capacity Act?
Are there valid reasons to act, even
without the patient’s consent? For
example, where others are at risk or
in order to address a service failure
that may affect others.
Do not begin your own
investigation or confront the
alleged abuser. The role of the
alerter is all about recognising
abusive situations: Look, listen,
clarify exactly why you are
concerned, then report it.
Multi-Agency working
Partnership working
‘No Secrets’ makes clear that
effective safeguarding can only be
achieved when agencies work
together in partnership. A person
making a safeguarding alert will
often only be seeing one piece of
what may be a very complicated
jigsaw - the aim of the subsequent
safeguarding process is to pull the
pieces of the jigsaw together and
then collectively decide on how to
respond to the identified concerns.
The West Midlands Policy and
Procedure.
A comprehensive adult
safeguarding policy and procedure
has been developed and signed up
to by partner agencies across the
whole of the West Midlands region.
Whatever your professional role,
and whatever organisation you
work for, the policy applies to you.
You can find the policy online,
together with Birmingham’s local
guidance, at:
http://www.bsab.org/publications/
policy-procedures-and-guidance/
What happens after an alert is
made
In Birmingham, if your alert is taken
on as a referral then Adults and
Communities will co-ordinate the
safeguarding response. This will
include scoping out who has had
any involvement with the adult at
risk, gathering information and
arranging further investigations as
required, and developing a
safeguarding plan. This process
may either be co-ordinated via a
face to face strategy meeting, or via
telephone discussions, but it will
normally involve representatives
from the local authority, police,
health and any relevant others. The
aim is to ensure that all parties
have a clear understanding of the
level of risk, have collectively
decided on the agreed response,
and have identified what their
individual responsibilities are.
You have a professional duty to
contribute to the information
gathering process, share your
perspectives about the situation,
and play whatever part is identified
for you or your agency in the
safeguarding plan. Making an alert
does not mean simply handing
the matter over to social services
to deal with.
The situation will then kept under
review. Further meetings or case
conferences may be arranged until
agreement is reached that the
issues have been satisfactorily
dealt with and the case can be
closed.
Multi-Agency working
Birmingham Safeguarding Adults
Board
with statutory guidance and
accepted best practice.
The Birmingham Safeguarding
Adults Board (BSAB) was
established to promote, inform and
support multi agency safeguarding
adults work in the city. It sets the
strategic direction of safeguarding
in Birmingham.
Key partner agencies across the
city have committed to the
Safeguarding Board via a
Memorandum of Understanding.
This provides the framework and
terms of reference for identifying
roles, responsibilities, authority and
accountability.
The Board is chaired by the Service
Director for Health and Well Being
on behalf of the Strategic Director
of Adults and Communities,
Birmingham City Council. It is
comprised of members from key
statutory agencies who work with
adults at risk of abuse in
Birmingham. Members have
sufficient seniority to represent their
organisation with authority, make
multi agency agreements and take
issues back for action.
The Board is tasked with
developing partnerships so as to
ensure effective local arrangements
are in place for the safeguarding of
adults at risk of harm, consistent
The Board meets regularly
throughout the year and ensures
that the multi-agency policy and
procedures are being used
effectively across the city. Working
arrangements are monitored to
ensure appropriate and proportional
outcomes for adults at risk.
The BSAB has four sub groups
which support it to discharge its
remit in relation to:
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Operations
Training and Communication
Serious Case Reviews
Mental Capacity and DoLS
For more information on adult
safeguarding in Birmingham, alert
forms, publications and further
resources, go to the BSAB website
at:
http://www.bsab.org/
Information sharing
A duty to share information
Information sharing between
organisations is essential to
safeguard adults at risk of abuse,
neglect and exploitation.
In serious case reviews across the
country, failing to share information
has often been identified as a
significant contributory factor when
things have gone wrong.
Health care professionals should
have the confidence to share
information in the best interests of
their patients, within the framework
set out by the Caldicott principles.
Be aware that the Caldicott2 review
stated that:
“The duty to share information
can be as important as the duty
to protect patient
confidentiality”
protect personal safety, or where
there are other legal reasons to do
so. In some instances the individual
will not have the capacity to
consent to disclosure of personal
information relating to them. Where
this is the case any disclosure of
information needs to be considered
against the conditions set out in the
Data Protection Act and must be in
their Best Interests as per the
Mental Capacity Act.
Information sharing protocols
The local information sharing
protocol for Safeguarding Adults
can be found at the Birmingham
safeguarding Adults Board website:
http://www.bsab.org/
Decisions about what information is
shared and with whom will be taken
on a case-by-case basis. But
whether or not information is shared
with or without the adult at risk’s
consent, the information should be:
Consent
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Information should always be
shared with consent wherever
possible, but a person’s right to
confidentiality is not absolute - it
may be overridden where there is
evidence that sharing information is
necessary in the public interest, is
required by law, is necessary to
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necessary for the purpose for
which it is being shared
shared only with those who
have a need for it
accurate and up to date
shared in a timely fashion
shared accurately
shared securely.
The Mental Capacity Act
What is Capacity?
Capacity is the ability to make a
specific decision at the time that
decision needs to be made. The
starting point is always that adults
have capacity to make their own
decisions in life, however in some
circumstances capacity can
become impaired - for example
when a person develops dementia.
This can mean that sometimes one
person has to make a decision for
or on behalf of another. The
decision could be about very simple
matter, or a very complicated one,
but either way it is a crucial
safeguard that all actions are taken
in line with the requirements of the
Mental Capacity Act. The Act
applies to anyone aged16+. There
is a comprehensive code of practice
you should use to inform your
actions in this area.
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Assessing Capacity:
To assess capacity, first consider:
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5 Basic Principles of the MCA:
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Presume capacity unless
demonstrated otherwise
Offer help and support to
individuals to make their own
decisions
Individuals have the right to
make eccentric or unwise
decisions
Always act in the individual’s
best interests when taking a
decision
Is there an impairment of,
or a disturbance in the
functioning of the mind or
brain?
Does this impairment affect
the person’s ability to make
the decision?
If the answer to either of the above
is ‘no’, then the person has capacity
to make their own choices. In order
to assess whether an impairment
in mental functioning actually
impacts on decision making ability
you must consider whether the
person can:
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Take the less restrictive
option wherever possible
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Understand the information
relevant to the decision
Retain the information
Use or weigh up the
information as part of the
process of making the
decision
Communicate their decision
If the answer to any of these is ‘no’
then the person does not have
capacity and the decision may then
need to be made on their behalf.
The Mental Capacity Act
Before making a decision, you
should consider the following:
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Does the decision need to be
made without delay?
Will the person regain
capacity?
Can the decision wait until
the person has regained
capacity?
Remember that capacity can
fluctuate. You are not making a
blanket judgement about the
person’s decision making ability,
you are looking a specific decision
at the time it needs to be made. If
you do have to make a decision for
someone else, you must always act
in their best interests.
Best Interests
When assessing what is in a
person’s best interests you should
consider:
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The past and present wishes
and feelings of the person
The beliefs and values of the
person
Whether the person has
made any advanced
decisions
As far as possible, the decision
maker should consult with other
people (friends and family etc) and
should take their views into account
when making the decision.
If, on the balance of probability, you
believe that someone does not
have capacity, and you then act in
line with the principles of the MCA
and in that person’s best interests,
you are then protected from liability.
Who assesses capacity?
Anyone can assess capacity. You
do not have to be a specialist to do
so, particularly for simple day to day
decisions. However if you are
unsure, seek support from your
organisational lead.
Recording your actions
For more complex decisions you
should always record (a) how you
assessed capacity and (b) how you
reached your best interest decision.
Holding a ‘best interests meeting’ to
record and demonstrate the
decision making process and to
evidence who was consulted is an
effective way to do this
For very complicated decisions, or
in the event of serious dispute, seek
specialist advice from within your
organisation. If necessary, the
matter can be referred to the Court
of Protection for resolution.
Deprivation of Liberty (DOLS)
What is DOLS?
The Deprivation of Liberty
Safeguards 2009 (DoLS) are an
amendment to the Mental Capacity
Act 2005. They provide a legal
framework to protect persons (aged
over18 years) who lack the capacity
to consent to the arrangements for
their treatment or care, in
circumstances where that treatment
or care can only be delivered with a
level of restriction or restraint that
amounts to a deprivation of liberty.
Where does DOLS apply?
The safeguards only apply to
persons in a hospital or a care
home setting, in circumstances
where the mental health act is not
applicable. For example, a person
with dementia who is admitted to
medical unit for treatment they
need and which is in their best
interests, but who is very confused
and repeatedly attempts to leave.
How is DOLS authorised?
DOLS is a safeguard to ensure that
where deprivation of liberty is
necessary it is scrutinised and
authorised rather than applied
arbitrarily. There is a legal duty on a
hospital or care home to apply for
authorisation to the Local Authority
if they believe they are depriving an
individual of their liberty. The Local
Authority will then commission six
separate assessments from
independent assessors in order to
ascertain (a) whether deprivation of
liberty is taking place and
(b) whether it is necessary and
justifiable. Written authorisation will
then be provided where
appropriate. DOLS is a statutory
process and it is essential that
practice in this area is robust: the
Court of Protection is the final
decision maker in the event of
dispute, and has on occasion
highlighted high profile failings in
practice which have had serious
implications for the parties involved.
Your responsibilities
If you believe that someone in a
hospital or care home setting is
being deprived of their liberty,
discuss the matter directly with the
unit manager. Where care cannot
be delivered in a less restrictive
way, the unit may need to make a
DOLS application. DOLS is in no
way a punitive process but it is an
important safeguard to protect the
rights of vulnerable people - so if,
after discussion, you still feel that
appropriate actions are not being
taken by the hospital or care home
you should raise the matter with the
Local Authority DOLS team on
0121 675 1684.
PREVENT
What is PREVENT?
Prevent is part of the
Government’s counter-terrorism
strategy. It aims to reduce the risk
of vulnerable people being
exploited by radicalisers and
subsequently drawn into terrorist
related activity. Prevent is not about
criminalising people – it is about
reducing the risk of that happening
by intervening early.
Your role in Prevent
Healthcare workers have a key role
in delivering the Prevent agenda.
On daily basis we meet and treat
individuals who may be open to
exploitation by radicalisers. The key
challenge for the health sector is to
ensure that staff can identify signs
that someone is potentially being
drawn into terrorism, are aware of
the support that is available, and
are then confident in referring the
person for on for further support.
How does Prevent work?
Prevent works in the same broad
way as safeguarding does: by
recognising vulnerability, flagging
up concerns, and then supporting
vulnerable people through effective
multi-agency working. If you have
concerns that an individual is at risk
of radicalisation, you should raise
these concerns with your
organisational Prevent lead or
Safeguarding lead. Referrals may
then go to a multi-agency panel
called Channel for consideration
and response.
Building Partnerships, Staying
Safe
The Department of Health has
developed a guidance toolkit to
assist in implementing Prevent in
the NHS. It is called, ‘Building
Partnerships, Staying Safe’. You
can download a copy at:
https://www.gov.uk/government/
publications/building-partnershipsstaying-safe-guidance-forhealthcare-organisations
Health WRAP
In conjunction with the Home
Office, the Department of Health
has also developed a workshop
specifically tailored to the
healthcare sector, known as Health
WRAP (Working to Raise
Awareness of Prevent). Please
contact your organisation's
Prevent or Safeguarding lead for
further information about
awareness raising, training or the
Prevent agenda.
Guidance and resources
There are numerous online
resources available to support your
individual practice and to aid
development of effective
safeguarding structures within your
organisation. Some of these
resources are listed below. Contact
details for the CCG safeguarding
nurses are also listed at the back of
this set of prompt cards.
Safeguarding Adults: The role of
health service managers and their
boards (DoH 2011)
Safeguarding Adults: The role of
health service practitioners (DoH
2011)
Safeguarding Adults: The role of
NHS commissioners (DoH 2011)
Safeguarding Adults: Self
assessment and assurance
framework (DoH 2011)
All at:
https://www.gov.uk/government/
publications/safeguarding-adultsthe-role-of-health-services
Statement of government policy on
Adult Safeguarding (DoH 2013):
https://www.gov.uk/government/
publications/adult-safeguardingstatement-of-government-policy-10may-2013
Safeguarding vulnerable people in
the reformed NHS: accountability
and assurance framework (NHS
England, 2013):
http://www.england.nhs.uk/wpcontent/uploads/2013/03/
safeguarding-vulnerable-people.pdf
Association of directors of adult
social services (ADASS)
safeguarding resources:
http://www.adass.org.uk/index.php?
otion=com_content&id=522&Itemid
=406
Social care institute for excellence
(SCIE) safeguarding resources:
http://www.scie.org.uk/adults/
safeguarding/index.asp
Ministry of Justice mental capacity
act guidance:
http://www.justice.gov.uk/protectingthe-vulnerable/mental-capacity-act
Social care institute for excellence
(SCIE) mental capacity act
e-learning resource:
http://www.scie.org.uk/publications/
elearning/mentalcapacityact/
Birmingham Safeguarding Adults
Board (BSAB):
http://www.bsab.org/
Safeguarding Adult Lead Nurses
Joe Martin
07971 462 434
[email protected]
Heidi Osborne
07545 422 697
[email protected]