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This page contains relevant information and guidance relating to Safeguarding Adult Reviews published by Warwickshire Safeguarding and their Rapid Reviews.

Safeguarding Adults Reviews (SARs) provide a process for all partner agencies to identify the lessons that can be learned from particularly complex or serious safeguarding adults cases, where an adult in vulnerable circumstances has died or been seriously injured and abuse or neglect has been suspected.

The SAR process provides an opportunity for extended learning beyond single organisations, to allow changes/improvements to be made in policy, practice and procedures, where identified.

The SAR protocol and guidance has been developed to help provide further clarity and definition of the roles, responsibilities and processes for undertaking a SAR; and improve awareness, understanding and confidence in the use of the review process, as a means of extended learning.

Download: WS SARs Protocol and Guidance v4.0


s44 of the Care Act 2014:

(1) An SAB must arrange for there to be a review of a case involving an adult in its area with needs for care and support (whether or not the local authority has been meeting any of those needs) if—

(a) there is reasonable cause for concern about how the SAB, members of it or other persons with relevant functions worked together to safeguard the adult, and
(b) condition 1 or 2 is met.

(2) Condition 1 is met if—

(a) the adult has died, and
(b) the SAB knows or suspects that the death resulted from abuse or neglect (whether or not it knew about or suspected the abuse or neglect before the adult died).

(3) Condition 2 is met if—

(a) the adult is still alive, and
(b) the SAB knows or suspects that the adult has experienced serious1 abuse or neglect.

(4) An SAB may arrange for there to be a review of any other case involving an adult in its area with needs for care and support (whether or not the local authority has been meeting any of those needs).

Rapid Review

Any agency or professional body, elected members, MPs, the Coroner or the individual concerned, or a family member may refer cases to Warwickshire Safeguarding for consideration of a SAR. Referrals must be made in writing using the SAR referral form.

Upon receipt of a SAR referral the Chair of the Safeguarding Reviews Subgroup will determine whether or not additional scoping information is to be requested from partner agencies, this takes the form of a Rapid Review.

The purpose of a rapid review is to:

  • gather the facts about the case, as far as they can be readily established at the time
  • discuss whether there is any immediate action needed to ensure the adults safety and share any learning appropriately
  • consider the potential for identifying improvements to safeguard and promote the welfare of adults with care and support needs
  • decide what steps they should take next.

All agencies who have been involved with the subject adult or will be required to contribute to the rapid review. An initial scoping of agencies’ intervention will be completed, and other relevant information will need to be rapidly gathered.

To support this, agencies are asked to produce an Individual Agency Summary.

The purpose of the initial scoping and information sharing is to gather the basic facts about the case, including determining the extent of agency involvement with the adult.

More detailed information will be sought if the rapid review concludes the case has the potential to identify national or local learning and a decision is made to recommend a Safeguarding Adult Review.


The responsibility for learning lessons from serious safeguarding incidents lies locally with the Safeguarding Reviews Subgroup, safeguarding partners (local authorities, chief officers of police and clinical commissioning groups), and Warwickshire Safeguarding Business Team.

SAR Reports and Briefings

Below are links to the Safeguarding Adult Reviews, Alternative Learning Reviews and their linked Briefings published by Warwickshire Safeguarding;

A Safeguarding Adult Review has been undertaken in relation to the case of ‘Peter’ published September 2020.

Please see below the full report and a statement issued by Warwickshire Safeguarding Partnership:

'Peter' Safeguarding Adult Review - Full Report
'Peter' Safeguarding Adult Review - WSP Statement

'Peter' - Lessons Learned Briefing 
Self-Neglect - 7-minute Briefing



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Safeguarding Briefings

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7-Minute Briefings
Lessons Learned Briefings
Quarterly News Bulletin

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