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Section 4: Adult Safeguarding Procedures

Adult Safeguarding Procedures

The Experience of the Adult at Risk, Section 42 Flowchart, Summary and Timescales

4.1 Context

The main objective of adult safeguarding procedures is to provide guidance to enable adults to be kept safe from abuse or neglect and to allow for immediate action to be taken where required in order to achieve this.

The procedures are a means for staff to combine principles of protection and prevention with the adult’s self-determination, respecting their views, wishes and preferences in accordance with Making Safeguarding Personal.

They are a framework for managing safeguarding interventions that are fair and just, through strong multi-agency partnerships that provide timely and effective prevention of and responses to abuse and neglect.

All organisations who work with or support adults experiencing, or who are at risk of, abuse and neglect may be called upon to lead or contribute to a safeguarding concern and need to be prepared to take on this responsibility.

Guidance is often criticised for over‐standardising practice and undervaluing the skills required when applying policies in diverse circumstances. The key focus is on using professional skills to gain a real understanding of what the adult wants to achieve to enable them to feel safer and what action is required to help them to achieve it. See flowcharts commencing below for further information.

4.2  The Four Stage Process

The procedures section has been structured within a Four Stage Process:

Before going through each stage of the process in depth, the next section will define roles and responsibilities and provide context within which the procedures operate.

4.3 Responsibilities

4.4  Local Authority and NHS Partnerships

Section 6(7) of the Care Act requires a local authority to co-operate with each of its relevant partners, and each relevant partner must co-operate with the local authority, in the exercise of their respective functions relating to adults with needs for care and support and to carers. The Act specifies those relevant partners and how cooperation should take place.

‘Local authorities can continue to enter into partnership arrangements with the NHS for the NHS to carry out a local authority’s ‘health-related functions’ (as defined in the 2000 Regulations (the NHS Bodies and Local Authorities Partnership Arrangements Regulations 2000). This effectively authorises NHS bodies to exercise those prescribed functions, including adult safeguarding functions. These arrangements are ‘partnership arrangements’ rather than ‘delegations’. In addition, by virtue of Regulation 4 of the 2000 Regulations, arrangements may only be entered into ‘if the partnership arrangements are likely to lead to an improvement in the way in which those functions are exercised’. The local authority would still remain legally responsible for how its functions (including adult safeguarding) are carried out via partnership arrangements.’ (Department of Health March 2015).

Within this policy and procedures, where there are partnership agreements under Section 75 of the NHS Act 2006 with Mental Health Trusts, appropriately trained managers within the Trust can act on behalf of the local authority to undertake adult safeguarding duties. Where this is done, the legal responsibility for safeguarding remains with the local authority. This is in particular reference to who can act as a Safeguarding Co-ordinator, which is a role particular to the local authority and its Section 75 partners under the above agreements and local protocols.

4.5 Safeguarding Concerns Manager / Lead in all Organisations

Safeguarding Concerns Manager / Lead throughout means the staff member responsible in an organisation to provide:

  • Managerial support and direction to staff in that organisation;
  • Decision making for concerns raised by members of staff and/or members of the public.

4.6 Safeguarding Adult Reporting Points

Each organisation must have its own operational guidance on how it manages adult safeguarding concerns, including a list of reporting points with up-to-date contact details, so that staff and the public know how to report abuse and neglect.

Reporting points may be through a Customer Contact Centre, specific access team or through a MASH, or by other locally agreed arrangements.

The local authority is the main reporting point even if others have their own and all local authorities should provide reporting points that are accessible outside normal working hours, in order to respond to urgent concerns.

Refer to local authority websites.

4.7 Lead or Delegated Enquiry Officer

An Enquiry Officer is responsible for undertaking actions under adult safeguarding.

  • The Lead Enquiry Officer is a member of the local authority who will retain responsibility for undertaking actions under Section 42 enquiries.
  • A Delegated Enquiry Officer is a member of another agency undertaking the enquiry on the local authority’s behalf (for example an entrusted enquiry).
  • In some instances there is a lead enquiry officer supported by other staff also acting as enquiry officers, where there are complex issues or additional skills and expertise is required.

4.8 Safeguarding Co-ordinator

The Safeguarding Co-ordinator is the member of staff who manages the overall safeguarding function within the local authority.

4.9 Feedback

All adult safeguarding concerns referred to the local authority should be assessed to decide if the criteria for adult safeguarding are met. Keeping the person who reported the concern informed is an essential requirement under this policies and procedures.

Feedback provides assurance that action has been taken whether under adult safeguarding or not. Organisations raising a concern may want to challenge or discuss the decision(s) and need to be updated on what action has been taken. It is more likely that the public will continue to report concerns, where there is an acknowledgement that their concern has reached the right agency and is being taken seriously.

Feedback to the wider community needs to take account of confidentiality and requirements of the Data Protection legislation.

4.10 Sharing Information with People Alleged to have Caused Harm

The principles of natural justice must be applied, consistently with the overriding aim of safety and the requirements of the Data Protection legislation. Providing information on the nature and outcomes of concerns to people alleged to have caused harm also needs to be seen in the wider context of prevention; for example, information can be used to support people to change or modify their behaviour. The person/organisation that is alleged to be responsible for abuse and/or neglect should be provided with sufficient information to enable them to understand what it is that they are alleged to have done or threatened to do that is wrong and to allow their view to be heard and considered. Whilst the safety of the adult remains paramount the right of reply should be offered where it is safe to do so. Decision making should take into consideration:

  • The possibility that the referral may be malicious;
  • The right to challenge and natural justice;
  • Whether there are underlying issues for example employment disputes;
  • Family conflict;
  • Relationship dynamics;
  • Whether it is safe to disclose particularly where there is domestic abuse;
  • Compliance with the Mental Capacity Act 2005.

Sharing information should be provided in a way that will not exacerbate the situation, and acknowledges that the Data Protection legislation applies to people alleged to have caused harm as well as the adult at risk. The person alleged to have caused harm has a right to know what personal information relating to them is held.

If the matter is subject to Police involvement, the Police should always be consulted so any criminal investigation is not compromised.

The Local Government Ombudsman and the Parliamentary and Health Ombudsman are both useful sources to explore case examples. The Information Commissioner provides advice on sharing information.

4.11 Dealing with Repeat Allegations

All safeguarding concerns should be considered on their own merit. An adult who makes repeated allegations that have been investigated and decided to be unfounded should be treated without prejudice. Where there are patterns of similar concerns being raised by the adult within a short time period, a risk assessment and risk management plan should be developed and a local process agreed for responding to further concerns of this nature from the adult.

All organisations are responsible for recording and noting where there are such situations and may be asked to contribute to a multi-agency response. Information sharing to assess and analyse data is essential to ensure that adults are safeguarded and an appropriate response is made. Staff should also be mindful of public interest issues.

In considering how to respond to repeated concerns the following factors need to be considered:

  • The Mental Capacity and safety of the adult whom the concern is about;
  • The strength of the support networks available to the adult;
  • Wishes of the adult and impact of the concern upon them;
  • Impact on important relationships;
  • Level of risk.

4.12 Dispute Resolution and Escalation

Professional disagreements should be resolved at the earliest opportunity, ensuring that the safety and wellbeing of the adult remains paramount. Challenges to decisions should be respectful and resolved through co-operation. Disagreements can arise in a number of areas and staff should always be prepared to review decisions and plans with an open mind. Disagreements should be talked through and appropriate channels of communication established to avoid misinterpretation.

In the event that operational staff are unable to resolve matters, more senior managers should be consulted. Multi-agency meetings may be a helpful way to explore issues with a view to improving practice. In exceptional circumstances or where it is likely that partnership protocols are needed the SAB should be appraised.

In the case of care providers, unresolved disputes should be raised with the relevant Managers leading on the concern and commissioners.

4.13 Cross-Boundary and Inter-Authority Adult Safeguarding Enquiries

Risks may be increased by complicated cross-boundary arrangements, and it may be dangerous and unproductive for organisations to delay action due to disagreements over responsibilities.

 The local authority for the area where the abuse occurred, has the responsibility to carry out the duties under Section 42 Care Act 2014, but there should be close liaison with the ‘placing authority’.

The ‘placing local authority’ continues to hold responsibility for commissioning and funding a placement. However, many people at risk live in residential settings outside the area of the placing authority. In addition, a safeguarding incident might occur during a short-term health or social care stay, or on a trip which is outside of the local authority area where the person lives requiring Police action in that area, or immediate steps to protect the adult while they are in that area. A safeguarding concern should be raised in the local authority area where the alleged abuse took place The outcome of the enquiry should be shared with the ‘placing authority’.

For further information, see the following link https://www.adass.org.uk/media/5414/adass-guidance-inter-authority-safeguarding-arrangements-june-2016.pdf

The experience of the adult at risk

The procedures to deliver this

Section 42 Flowchart Summary and Timescales

The time taken to respond to a safeguarding concern(s) will depend on a range of factors, including the wishes and needs of the adult at risk, as well as the nature, seriousness and complexity of the concern(s).

*The timescales described within these procedures are not intended as performance indicators, however provide useful targets for practice that are achievable in many cases. The timescales need to reflect:

• All other investigations such as NHS Serious Incidents (SI)

• The investigation that takes priority – this needs to be agreed on a case by case basis

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