Review Opportunities

Herefordshire Safeguarding Adults Board

The Herefordshire Safeguarding Adult Board is seeking to identify an independent reviewer to complete a newly commissioned Safeguarding Adult Review (SAR) to begin in January 2026.

Case Overview

Miss X was admitted to County Hospital for maternity care, during which an ITU admission was required.  Self-neglect was evidenced through matted hair, toenails overgrown over the ends of toes, very long fingernails and missing and broken teeth. The Safeguarding Midwife identified that Miss X may have a Learning Disability and had multiple agency involvement over a period of years with advocacy previously recommended to the Children’s social worker for the then unborn child.  No referral is known to have been placed. Miss X has been reported across services as being not engaged, although it is unclear that if agencies had worked together to consider any reasonable adjustments which may have been required. Discussed previously at MARAC. Miss X is previously known to self-harm, have experienced poor mental health, significant ACE’s and childhood trauma; have excess alcohol intake (previously documented as consuming 133 units per week) and be at risk of exploitation. There appears to be multiple missed opportunities to support during health encounters whilst under midwifery care and further missed opportunities during encounters across other health agencies.

Review themes

Key areas of focus are:

• Learning disability: Importance of sharing the details of learning disabilities to support working practice and managing that over time and across agencies
• Exploitation: Numerous allegations of sexual assault, financial exploitation from family members regarding income from benefits, alcohol misuse across family members. History of domestic abuse relationships. Care and support needs identified.
• Engagement: Struggling to engage even when persistent attempts are made, professional understanding the underlying causes of this.
• Narrative around baby being removed: there have been recent cases of suicide and self-harm in similar cases, there needs to be a proactive plan around this. 
• LD alerts on systems
• Mental Capacity Assessments: GP may have felt there was greater capacity due to better levels of engagement, but this was not seen in other areas.
• Self-neglect: Was this fully considered due to her younger age.
• Home visits: Were these being undertaken in order to get a full understanding
• Transitions: This process needs full consideration by agencies so that this is fully embedded.

 
How to apply

Please submit the following:

• Current CV and expression of interest letter (no longer than 3 sides) to evidence how you meet the requirements. 
• Links to examples of your written work.
• A statement that you do not have any current connection to the agencies/organisations/individuals involved in the review.
• Confirmation of your availability 

Please express an initial interest in this opportunity by clicking here to send us a whats app message. You can also ask any questions and clarifications using the link as well. 

The deadline for receipt of your application is midnight 9th December 2025.

Documents in support of your application will be received via our reviews inbox: [email protected]