Skin Damage and Safeguarding (Adults)

Guidance has been developed to provide information on what to do if you are concerned that presenting skin damage is due to neglect/self-neglect and/or poor practice. The guidance will support you to decide wither to refer through the Safeguarding Adult Procedure.

Reporting skin damage through the Safeguarding Adults procedure

This document provides information to professionals, frontline staff and care providers including staff in residential and nursing care homes and home care:

Where concerned that presenting skin damage is due to neglect/self-neglect and/or poor practice.
It will help to decide whether to refer through the Safeguarding Adults Procedure.

Damage to a person’s skin can include bruises, scratches, skin tears, pressure ulcers. Skin damage has many causes which include neglect, self-neglect and acts of omission and should be looked at on an individual basis. Some causes of skin damage relate to the individual person, including factors such as the person’s medical conditions, nutrition and hydration.

Pressure ulcers are caused by sustained pressure, where the person’s individual tissue tolerance and susceptibility to pressure has been overcome. Not all pressure ulcers can be prevented and the risk factors for each person should be looked at on an individual basis.

Pressure ulcers may occur as a result of neglect/self-neglect or acts of omission, including ignoring medical or physical care needs, failure to provide access to appropriate health care and support, medication, nutrition and heating. In some instances this can result in significant preventable skin damage.

If there is evidence that skin damage is a result of neglect/self-neglect or acts of omission you must:

Record the evidence in accordance with your organisations own procedures (e.g. completion of body map, patient or resident’s notes, incident reports).
Report a safeguarding concern to Social Care Direct (or relevant LA), giving clear reasons why you believe the skin damage may be due to neglect/acts of omission/abuse.

Report the incident to your own organisation as well, using your own incident reporting system.

Points to consider:

Is the skin damage new? Has it happened before? Why/how it happened?
Has there been a recent change in the person’s health that would account for a sudden change in their skin?
Have all appropriate steps been taken to prevent damage occurring/deteriorating?
Look at the skin damage & the person & their environment & consider:
Have all practicable steps been taken to prevent skin damage from occurring or deteriorating further?
Have the risks been documented?
Has appropriate care planning/care delivery been completed?

Is there evidence of poor practice resulting in neglect or an act of omission?

Contacts

Adult Social Care 01325 406111 (Darlington Borough Council) or relevant Local Authority
NHS Tissue Viability Service 01325 743179
CCG Adult Safeguarding Lead 0191 389 8607

Further reading:

Nice Guidance: pathways.nice.org.uk/pathways/skin-conditions www.nice.org.uk/advice/mib124

Department of Health & Social Care: Safeguarding Adults Protocol: Pressure Ulcers and raising a safeguarding concern