109 The Dorset multi-agency framework for the prevention and management of pressure ulcers (updated 2019) is available on each Partner organisation’s intranet and should be read alongside this Guidance. The Dorset multi-agency framework for the prevention and management of pressure ulcers (updated 2019) is available on each Partner organisation’s intranet and should be read alongside this Guidance Pressure ulcers are considered an important part of the wider safeguarding agenda, the Care Act (2014) sets out the criteria for when a Local Authority may have reasonable cause to suspect an adult in their area: ‘…. (a) has needs for care and support (whether or not the authority is meeting any of those needs), (b) is experiencing, or is at risk of, abuse or neglect, and (c) as a result of those needs is unable to protect himself or herself against the abuse or neglect or the risk of it.’ In some cases, pressure ulcers may be due to neglect. Neglect is a form of abuse which involves the deliberate withholding or unintentional failure to provide appropriate and adequate care and support, where this has resulted in, or is highly likely to result in, significant preventable skin damage. Self-neglect can also be a contributary factor in the development of pressure injuries, ulcers or sores. Skin damage can be due to a number of pre-disposing factors, such as the individual’s medical condition and co-morbidities. This can compromise a person’s skin integrity. External factors such as poor care, ineffective multi-disciplinary team working and a lack of appropriate or inappropriate use of resources, such as equipment and staffing levels can also be a factor. It is recognised that not all skin damage can be prevented and therefore the risk factors in each case should be reviewed on an individual basis before a safeguarding referral is considered. All cases of actual or suspected neglect must be referred through the local safeguarding procedures. A safeguarding referral should be considered if there is: Significant skin damage (Category 3, 4, or an unstageable ulceration). There are reasonable grounds to suspect that it could have been avoided. Inadequate measures have been taken to detect or prevent the development of a pressure ulcer. There is inadequate evidence to make a conclusive assessment from the above information. In deciding about the need for a safeguarding referral: a medical history of the problem should be obtained contact must be made with former care providers for information, especially if the person’s care has recently been transferred clarification must be obtained about the cause of the damage photographs of pressure ulcers should be considered in order to aid clarity, with the permission of the individual. The Safeguarding Adults Protocol: pressure ulcers and raising a safeguarding concern (2024) offers a framework for practitioners to utilise when considering a safeguarding referral for a pressure ulcer. Appendix 16 – Local pressure ulcer protocol
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