Section 1: Wellbeing, Values and Principles

Wellbeing, Values and Principles

• 1.1 Wellbeing
• 1.2 Values – Supporting Adults at Risk of Abuse and Neglect
• 1.3 Equality and Diversity
• 1.4 Duty of Care
• 1.5 Defensible Decision Making
• 1.6 Principles
• 1.7 Risk Management
• 1.8 Co-operation and Information Sharing
• 1.9 Confidentiality
• 1.10 Accessible Information Standard
• 1.11 Information and Advice

1.1 Wellbeing

Section 1 of the Care Act 2014 states that local authorities must promote wellbeing when carrying out any of their care and support functions in respect of a person. This may sometimes be referred to as ‘the wellbeing principle’ because it is a guiding principle that puts wellbeing at the heart of care and support.

The Care Act 2014 Guidance supports the need for safeguarding to be person led and outcome focused. For safeguarding, this would include safeguarding activities in the widest community sense and is not confined to safeguarding enquiries under Section 42 of the Care Act 2014

“14.15. Making safeguarding personal means it should be person-led and outcome-focused. It engages the person in a conversation about how best to respond to their safeguarding situation in a way that enhances involvement, choice and control as well as improving quality of life, wellbeing and safety.”

All organisations working with adults who are or may be at risk of abuse and neglect, must aim to ensure that they remain safeguarded from it. This should underpin every activity through consistent safeguarding adults work.

The wellbeing principle should apply to all agencies involved in safeguarding adults.

Wellbeing is a broad concept. It is described as relating to the following areas in particular:

• Personal dignity (including treatment of the individual with respect);
• Physical and mental health and emotional wellbeing;
• Protection from abuse and neglect;
• Control by the individual over their day-to-day life (including over care and support provided and the way they are provided);
• Participation in work, education, training or recreation;
• Social and economic wellbeing;
• Domestic, family and personal domains;
• Suitability of the individual’s living accommodation;
• The individual’s contribution to society.

There is no hierarchy in the areas of wellbeing listed above – all are equally important. There is also no single definition of wellbeing, as how this is interpreted will depend on the individual, their circumstances and their priorities.

Safeguarding may need to support or offer the adult the opportunity to develop, maintain, a “private life”. Having a private life includes the right of a person to define the “inner circle” in which they choose to live their life, including in particular the right to choose those with whom they do and those with whom they do not want to establish, develop or continue a relationship.

The Care Act puts adult safeguarding on a legal footing and requires each local authority to set up a Safeguarding Adults Board (SAB – Section 43) with core membership from the local authority, the Police and the NHS (specifically local Clinical Commissioning Group/s). It has the power to include other relevant bodies (See Appendix 2). One of the key functions of the SAB is to ensure that the policies and procedures governing adult safeguarding are fit for purpose and can be translated into effective adult safeguarding practice.

Bradford, Calderdale, Kirklees, North Yorkshire Wakefield and York SABs have adopted this policy and procedures so that there is consistency across the area in the way in which adults are safeguarded from neglect or abuse. All organisations involved in safeguarding should adopt this policy and procedures in respect of their relevant roles and functions, but may wish to add local operational practice guidance/protocols. This policy and procedures should also be used in conjunction with partnerships and each individual organisation’s procedures on related issues including:  fraud, disciplinary procedures, whistleblowing procedures,  health and safety, and managing allegations against staff. N.b. this list is not exhaustive.

1.2 Values – Supporting Adults at Risk of Abuse and Neglect

• People are able to access support and protection to live independently and have control over their lives;
• Appropriate safeguarding options should be discussed with the adult at risk according to their wishes and preferences. They should take proper account of any additional factors associated with the individual’s disability, age, gender, sexual orientation, race, religion, culture or lifestyle;
• The adult at risk should be the primary focus of decision making, determining what safeguards they want in place and provided with options so that they maintain choice and control;
• All action should begin with the assumption that the adult at risk is best- placed to judge their own situation and knows best the outcomes, goals and wellbeing they want to achieve;
• The individual’s views, wishes, feelings and beliefs should be paramount and are critical to a personalised way of working with them;
• There is a presumption that adults have mental capacity to make informed decisions about their lives. If someone has been assessed as not having mental capacity, to make decisions about their safety, decision making will be made in their best interests as set out in the Mental Capacity Act 2005 and Mental Capacity Act Code of Practice;
• People will have access to supported decision making;
• The adult at risk should be the primary focus of decision making, determining what safeguards they want in place and have support to explore options so that they can take, exercise and maintain choice and control over their own lives;
• All decisions should be made with the adult at risk and promote their wellbeing and be reasonable, justified, proportionate and ethical;
• Timeliness should be determined by the personal circumstances of the adult at risk;
• Every effort should be made to ensure that adults at risk are afforded appropriate protection under the law and have full access to the criminal justice system when a crime has been committed.

1.3 Equality and Diversity

It is every person’s human right to live a life free from abuse and neglect. Every adult with care and support needs has an equal right to support and protection within this policy and procedure regardless of their individual differences or circumstances.

This policy and procedure applies equally to:

• All adults at risk as defined within this policy;
• All agencies;
• All forms of abuse.

Throughout safeguarding adults due regard must be given to individual differences, including age, disability, religion or belief, sex, sexual orientation, race or racial group, caring responsibilities, class, culture, language, pregnancy and marital or civil partnership status.

1.4 Duty of Care

Everyone has a clear moral and/or professional responsibility to prevent or act on incidents or concerns of abuse or neglect.  A duty of care to an adult at risk is fulfilled when all the actions reasonably expected of a person in their role have been carried out with appropriate care, attention and prudence. Duty of care will involve actions to keep an adult safe from harm when they are in your care, using services or exposed to your activities and will also include respecting the adult’s  wishes and protecting and respecting their rights.

The nature of an individual’s duty of care will vary according to their role.  In all cases however, it will involve taking allegations or concerns seriously, and owning one’s responsibilities to safeguard the adult at risk.

1.5 Defensible Decision Making

Effective professional judgement and decision making is the key to responding to a safeguarding concern(s). A duty of care in relation to those decisions or judgement will be considered to be met where:

• All reasonable steps have been taken;
• Reliable assessment methods have been used;
• Information has been collated and thoroughly evaluated;
• Decisions are recorded, communicated and thoroughly evaluated;
• Policies and procedures have been followed;
• Practitioners and their managers adopt an investigative approach and are consultative and proactive.

Defensible decision making is about making sure that the reasons for decisions, as well as the decision itself, have been thought through and can be explained. Recording of those decisions should be made in a timely way in in line with each organisations guidance on recording.

1.6 Principles

This policy and procedures are based on The Six Principles of Safeguarding that underpin all adult safeguarding work.

EMPOWERMENT	Adults are encouraged to make their own decisions and are provided with support and information.	I am consulted about the outcomes I want from the safeguarding process and these directly inform what happens.
PREVENTION	Strategies are developed to prevent abuse and neglect that promote resilience and self-determination.	I am provided with easily understood information about what abuse is, how to recognise the signs and what I can do to seek help.
PROPORTIONATE	A proportionate and least intrusive response is made balanced with the level of risk.	I am confident that the professionals will work in my best interests and only get involved as much as needed.
PROTECTION	Adults are offered ways to protect themselves, and there is a coordinated response to adult safeguarding.	I am provided with help and support to report abuse. I am supported to take part in the safeguarding process to the extent to which I want and to which I am able.
PARTNERSHIPS	Local solutions through services working together within their communities.	I am confident that information will be appropriately shared in a way that takes into account its personal and sensitive nature. I am confident that agencies will work together to find the most effective responses for my own situation.
ACCOUNTABLE	Accountability and transparency in delivering a safeguarding response.	I am clear about the roles and responsibilities of all those involved in the solution to the problem.

1.7 Risk Management

Safeguarding is fundamentally identifying and managing risk about the safety and wellbeing of an adult in line with the above six principles. The aim of risk management is:

• To promote, and thereby support, inclusive decision making as a collaborative  and  empowering  process,  which  takes  full  account  of  the individual’s perspective and views of primary carers;
• To enable and support the positive management of risks where this is fully endorsed by the multi-agency partners as having positive outcomes.

Effective risk management strategies identify risks and provide an action or means of mitigation against each identified risk, and have a mechanism in place for early escalation if the mitigation is no longer viable. Contingency arrangements should always be part of risk management. Risk assessments and risk management should take a holistic approach and partners should ensure that they have the systems in place that enable early identification, assessment and review of risk through timely information sharing and targeted multi-agency intervention.

Where an individual is not able to protect themselves without support, the aim should be to support them to make their own informed decisions which preserve their safety. However, people involved in safeguarding need to acknowledge that there is a balance to be struck between risk and an individual’s right to make their own informed decisions, even if others consider the decision to be unwise or puts the individual at risk. The importance of their right to make decisions about their own life, which is part of an individual’s well-being, needs to be considered as well as the safeguarding concern(s).

1.8 Co-operation and Information Sharing

Effective multi-agency working has been highlighted as important in learning from Safeguarding Adult Reviews (SAR’s). The local authority retains responsibility as the lead coordinating organisation. All other relevant organisations and partners, including NHS bodies; the Police and Probation Services and the Departments of Employment and Training owe legal duties in relation to the safeguarding of adults. Organisations contributing to effective inter-agency working can achieve this through creative joint working partnerships that focus on positive outcomes for the adult(s). Co-operation between organisations that take a broad community approach to establishing safeguarding arrangements, working together on prevention strategies and awareness raising also  supports  the  aims  and  objectives  of  Health  and  Wellbeing  Boards,  and Community Safety Partnerships.

Section 6 of the Care Act 2014 describes a general duty to co-operate between the local authority and other organisations providing care and support. This includes a duty on the local authority itself to ensure co-operation between its adult care and support, housing, public health and children’s services.

If an organisation is refusing to share information, the organisation conducting an enquiry can escalate to the SAB to consider using Section 45 of the Care Act 2014 powers, which puts an obligation on organisations to comply with a request for information in order that the SAB can perform its duties.

The Care Act 2014 sets out five aims of co-operation between partners which are relevant to care and support, although it should be noted that the purposes of co- operation are not limited to these matters. The five aims are:

• Promoting the wellbeing of adults needing care and support and of carers;
• Improving the quality of care and support for adults and support for carers (including the outcomes from such provision);
• Smoothing the transition from children’s to adults’ services;
• Protecting adults with care and support needs who are currently experiencing or are at risk of abuse or neglect, and;
• Identifying lessons to be learned from cases where adults with needs for care and support have experienced serious abuse or neglect.

Organisations that refuse to comply with requests for co-operation or information should provide written reasons for the refusal.

Sharing the right information, at the right time with the right people, is fundamental to good safeguarding practice, but it has been highlighted as a difficult area of practice. The Care Act 2014 Section 45 ‘supply of information’ duty covers the responsibilities of others to comply with requests for information as detailed above. Sharing information between organisations as part of day-to-day safeguarding practice is already covered in the common law duty of confidentiality, Data Protection, the Human Rights Act 1998 and the Crime and Disorder Act 1998.

Helpful guidance is set out in the Caldicott Principles.

Partner organisations may be asked to share information through agreed information sharing protocols. Each SAB should have a protocol in place for information sharing, with clear governance on how it will be implemented.

This co-operation and information sharing for safeguarding purposes is supported by all data protection legislation where there is a lawful basis, such as the Care Act, for sharing personal data and compliance with the Caldicott Principles will help to ensure that information sharing is justified and appropriate.

Local authorities and their relevant partners must respond to requests to co-operate under their general public law duties to act reasonably.

1.9 Confidentiality

A duty of confidentiality arises when personal information is obtained and/or recorded in circumstances where it is reasonable for the subject of the information to expect that the information will be held in confidence.

Adults at risk provide sensitive information and have a right to expect that the information that they directly provide and information obtained from others will be treated respectfully and that their privacy will be maintained.

The challenges of working within the boundaries of confidentiality should not impede taking appropriate action. Whenever possible, informed consent to the sharing of sensitive personal information should be obtained. However:

• Emergency or life-threatening situations may warrant the sharing of relevant information with the relevant emergency services without consent.
• The law does not prevent the sharing of sensitive, personal information within organisations. If the information is confidential, but there is a safeguarding concern, sharing it may be justified.
• The law does not prevent the sharing of sensitive, personal information between organisations where the public interest served outweighs the public interest served by protecting confidentiality – for example, where a serious crime may be prevented.

Whether information is shared with or without the adult’s  consent, the information sharing process should abide by the principles of the Data Protection legislation. In those instances where the person lacks the mental capacity to give informed consent, staff should always bear in mind the requirements of the Mental Capacity Act 2005 and whether sharing it will be in the person’s best interest.

The Data Protection legislation should not be a barrier to sharing information. It provides a framework to ensure that personal information about living persons is shared appropriately.

1.10 Accessible Information Standard

From 1st August 2016 onwards, all organisations that provide NHS care or adult social care are legally required to follow the Accessible Information Standard.

The standard aims to make sure that people who have a disability, impairment or sensory loss are provided with information that they can easily read or understand and with support so they can communicate effectively with health and social care services. https://www.england.nhs.uk/ourwork/accessibleinfo/

1.11 Information and Advice

The term ‘information’ means the communication of knowledge and facts regarding care. ‘Advice’ means helping a person to identify choices and/or providing an opinion or recommendation regarding a course of action in relation to care and support.

Information and advice is critical to preventing or delaying the need for services and, in relation to safeguarding, can be the first step to responding to a concern.  Section 4 of the Care Act states that local authorities must: ‘establish and maintain a service for providing people in its area with information and advice relating to care and support for adults and support for carers.’ This includes information and advice about safeguarding and should include:

• How to raise concerns about the safety or wellbeing of an adult who has care and support needs;
• Awareness of different types of abuse and neglect;
• How people can keep safe, and how to support people to keep safe;
• The safeguarding adults process;
• How SABs work.

All organisations should ensure that they are able to provide this service and can signpost adults to receive the right kind of help by the right organisation.

Whereas information may be generic to a lesser or greater extent, advice needs to be tailored to the person seeking it, recognising people may need different mediums through which to communicate. It should, where possible, be provided in a way to help them understand the information being conveyed. This should be cognisant of the Equality Act 2010. ‘Reasonable adjustments’ should be made to ensure that disabled people have equal access to information and advice services. Reasonable adjustments could include the provision of information in accessible formats or with communication support.

Organisations have a number of direct opportunities to provide, or signpost people to information and advice, in particular for safeguarding:

• At first point of contact;
  • During or following an adult safeguarding enquiry;
  • Safeguarding planning;
  • Risk management;
  • Through complaints and feedback about a service which identifies a safeguarding concern.