When an adult who needs care and support either dies or suffers serious harm, and when abuse or neglect is thought to have been a factor, City of York Safeguarding Adults Board (CYSAB) may need to review what has happened. This is called a Safeguarding Adults Review or SAR for short.
Sometimes CYSAB will also arrange for a SAR to take place in other situations where they feel there might be learning for services.
These reviews are to see whether any lessons can be learned about the way organisations worked together to support and protect the person who suffered harm. The people carrying out the review understand this is likely to be a very difficult time for families, friends and carers, but they want to learn as much as possible about how to do things better in the future.
The CYSAB wants families and carers to be involved in the process as much as possible. They believe families, carers and where appropriate, the person who suffered harm should have the opportunity to discuss any concerns they may have and to share their thoughts and opinions.
This page tells you what happens when a SAR is required to be undertaken, what you should expect and the support the CYSAB offers.
The purpose of a SAR is to find out how organisations, agencies, carers and professionals can work better together in the future to keep adults at risk safe from abuse or neglect.
It is completely separate from any criminal investigation by the Police and/or the coroner and it concentrates on the work of the professionals, organisations and agencies who have been involved with the adult to look to see if they can learn anything from what has happened.
A SAR is not an enquiry into the cause of an individual death or injury. It does not look for someone to blame.
The CYSAB has a sub-group of professionals from different agencies who look at all requests for a review; this group then decides on whether a SAR needs to take place. If a review is required this group also decide how a review is to take place. This must then be approved by the Independent Chair of the CYSAB.
There are different ways in which a SAR can be done. Each SAR will involve gathering information from many sources. An independent person who has no involvement in the case will be asked to lead on the review and report back to the SAR sub-group. The SAR sub-group and the person leading the review will decide on what type of review will support effective learning and improvements to prevent future death or serious harm.
The SAR sub-group will try to ensure that there is appropriate involvement in the review process of professionals and organisations who were involved with the adult.
They will also decide the best way to involve the adult and/or their family. In some cases, it may be helpful to communicate with the person who caused the abuse or neglect.
An important part of undertaking a SAR is to ask you, the family, for your view. A person nominated by the CYSAB (usually the person leading the review) can arrange to meet with you to discuss the process and make sure you are kept up to date. A suitable date, time and venue will be arranged for this.
Having support during this meeting is encouraged, this could be another family member or a family friend, an advocate or any other professional you think appropriate. Home visits will be agreed if you wish or alternatively a venue of your choice will be considered. Sometimes a SAR can take several months to complete, but the nominated person will update you regularly and explain the reasons for any delays.
The independent person will be asked to provide the SAR sub-group with any learning and any improvement that may be required. The final report will be approved by the CYSAB.
CYSAB and the SAR sub-group will monitor the improvement plan over a period of time. The nominated person will talk to you about the outcome of the SAR and any lessons that have been learned.
There may be a report that is published on the CYSAB website; however, no individuals are named in it and no information is included that could lead to individuals involved being identified.
The CYSAB must publish an annual report which will include the findings of any SAR and subsequent improvement/s. These again will not contain any names.
If you have any questions about this process, please email the CYSAB Business Manager SAB@york.gov.uk.