Adult Safeguarding - Raising a Concern and the Decision Making Tool (DMT)

 MK Together has developed a Decision Making Tool to make it clearer and easier for people to understand what a safeguarding concern is and what to do with a concern.

Neglect and Acts of Omission – Pressure Ulcers

Pressure ulcers are primarily a clinical issue and should be referred to an appropriate health professional in the first instance. However, where there are obvious signs of neglect, this should be referred to adult safeguarding.

RESOLVE:

  • Single or isolated incident of Grade 1 or 2 pressure ulcer
  • Grade 3 & 4, Unstageable and Suspected Deep Tissue Injury or multiple grade 2 pressure ulcers where:
    • A care plan is in place
    • Action is being taken
    • Other relevant professionals have been notified
    • There has been full discussion with the person, their family or representative
    • There are no other indicators of abuse or neglect or unexplained deterioration

CONSULT:

  • Grade 3 & 4, Unstageable and Suspected Deep Tissue Injury pressure ulcers or multiple grade 1 and 2 pressure ulcers where:
    • The care plan has NOT been fully implemented
    • Deterioration has taken place without explanation – e.g. grade 2 has been re-graded as a grade 3/4 ulcer
    • It is NOT CLEAR that professional advice or support has been sought at the appropriate time. e.g. Tissue Viability Team
    • There have been other similar incidents or areas of concern
    • There are other indicators of abuse or neglect

REPORT:

  • If Department of Health safeguarding Adults Protocol pressure ulcers Decision Guide results in score of 15+
  • Grade 3 & 4, Unstageable and Suspected Deep Tissue Injury where:
    • The person has been assessed as NOT having mental capacity and treatment and prevention NOT provided
    • No assessment and care planning has not been completed or is of very poor quality
    • No professional advice or support has been sought at the appropriate time, e.g. Tissue Viability Team
    • There are other indicators of abuse or neglect
    • Evidence demonstrates this is part of a pattern or trend
    • A root cause analysis investigation has been referred for or started

Department of Health Safeguarding Adults Protocol: pressure ulcers and the interface with a safeguarding enquiry: https://www.gov.uk/government/publications/pressure-ulcers-safeguarding-adults-protocol

Last Updated: 29 July 2021