Speaking to people at risk and safety planning (adults and children)

This section describes operational processes to help professionals speak to children and adults at risk of going missing, and safety plan to prevent missing episodes.

Professionals should speak to people receiving care who may be at risk of going missing in an effort to prevent such an incident occurring and think about how to keep the person safe. Processes should be put in place to allow for these discussions at the point of admission to a regulated service, or at the start of the delivery of a care package by a domiciliary agency. Should a person have additional needs, or an issue with capacity, consider bringing a known and trusted person of theirs into the conversation.

For people who are at high risk of going missing (for example people who have been missing previously, people in ‘hotspot’ locations, or people who are identified as at risk by professionals during risk assessments on admission or when they are first assessed, this conversations may be a preventative measure in itself – many previously missing adults report not realising that they would be reported missing to the police. An opportunity to address issues with their care that might cause them to leave could be enough to prevent them from being reported missing the first place.

The conversation should be supportive, non-judgmental and conducted in a safe and neutral environment, led by the person at risk. It should be made clear that this conversation is taking place to help and support them to feel safe and able to ask for and accept help.

The conversation should avoid any language that could be perceived as threatening. The process that will need to be followed, which may include calling the police, should be explained in a way that is not punitive and does not make the patient, resident or service user feel that being reported missing will be used as a form of punishment.

Local partnerships should develop procedures for these conversations and assign responsibility to the most appropriate members of staff.

Conversations should include:

A discussion about when someone would be reported missing and what this will mean, including what information may need to be shared with other agencies. For example, a clear explanation of the expectations on a patient or resident in regards to where they should be at what times; what might trigger a member of staff to report them missing; what the police may then do in terms of investigation.

Space for the person at potential risk to discuss what might trigger them to go missing, what might help to mitigate this, and any concerns about the expectations put upon them. This should be an open conversation that allows people to raise concerns about anything they may not be happy with in terms of their care or restrictive measures put in place to make them safe. It is vital that any appropriate changes raised by this conversation are actioned.

A discussion about how the person can stay safe if they do leave the health or care setting, including how they can keep staff informed of what is happening if appropriate.

Recording relevant information about locations and activities that the person might attend or seek out if they go missing, as well as who may be appropriate if they do go missing.

Information from these conversations should be incorporated into people’s care plans or used to develop a trigger plan to be used in the event of them going missing. All information should be regularly reviewed and updated, and when appropriate, the information should be shared with other relevant agencies.

These conversations should also be reviewed in a broader sense to identify any persistent reasons that people are going missing; emerging themes that may inform prevention; or necessary changes to the local protocol and response.

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