The strategy stage could be a discussion (telephone or face to face) or a meeting. The lead agency will decide which approach is most appropriate.
A discussion would take place when:
If a discussion is held, it may still be necessary to hold a follow up meeting when the enquiry is deemed complex and / or there is a high risk of harm.
Where immediate action is needed to protect the adult, the information should be passed to the organisation that is in the best position to carry this out as quickly as possible. Agreement should be reached on what action will be taken.
A meeting may be held when the concerns are assessed to involve medium / high risk of harm and several organisations are involved.
Attendance at the strategy meeting should be limited to those who need to know and can contribute to the decision making process. Participants will be individuals from any organisation who have a role in investigating the allegation of abuse and / or in the assessment of the risk to the adult, or in relation to the person alleged to be causing the harm.
Participants should have sufficient seniority to make decisions at the meeting, particularly concerning their organisation’s role and the resources they may contribute to the agreed protection plan.
The list below is not exhaustive and participation at a strategy meeting should be decided on the circumstances of the case. However, as well representatives of the lead agency, a meeting may be attended by:
However, appropriate attendance of strategy meetings should be considered on an individual basis, and it may be equally as appropriate for only one or two agencies to be involved.
Every effort should be made prior to the meeting to explain its purpose to the adult and to discover their concerns, what they wish to happen and how they want to be involved in what is decided. The meeting must decide who will feed back any decisions made to the adult.
Any organisation requested to attend a strategy meeting should regard the request as a priority. If no one from the organisation is able to attend, they should provide information as requested and make sure it is available at the meeting. The strategy discussion / meeting will need to decide on a number of issues, as listed below.
The key issues of risk faced by the adult should be clarified:
If it is suspected a criminal offence has taken place, advice must be sought from the police as to when it would be appropriate to speak to the person allegedly causing the harm.
Decide who will interview the person allegedly causing harm and/or give them information about the allegations (and when this should happen). This may well be the interviewing officer of the organisation that has a duty to investigate.
The local multi-agency Information Sharing Agreement should be consulted within this process (see Information Sharing).
The primary concern must be the safety of the adult, but the person allegedly causing harm also has rights which need to be considered. Decisions about notifying the person allegedly causing harm need to be made at the strategy meeting, weighing up potential repercussions or further risk of harm, also in agreement with the police where there is or may be a criminal investigation.
If the person allegedly causing harm is also an adult, a decision must be made about how their needs are to be met during the enquiry. For example, if they lack capacity, they will also need someone who can represent them, possibly an IMCA.
Identify whether the person needs advice, support, assistance or services.
A decision should be made whether an organisation in which the alleged abuse or neglect has occurred may undertake an enquiry on the basis of an assessment of risk and harm to the adult.
Based on the outcome and where appropriate, employers should report workers to the statutory and other bodies responsible for professional regulation such as the General Medical Council and the Nursing and Midwifery Council. If someone is removed from their role providing regulated activity following a safeguarding incident the provider has a legal duty to refer to the Disclosure and Barring Service (DBS). The DBS must also be informed if the person leaves their role to avoid a disciplinary hearing following a safeguarding incident and the employer feels they would have dismissed the person based on the information provided. It is a legal duty to make a safeguarding referral to DBS if a person is dismissed or removed from their role due to harm to a child or a adult.
Safeguarding enquiries can involve more than one line of inquiry, and these need to be discussed and carefully coordinated at the strategy stage. Where a criminal investigation is taking place decisions must be reached in a strategy discussion or meeting between the police and other involved organisations about what actions they can take and when. This ensures that the criminal investigation is not compromised and that other organisations are able to take necessary action at the appropriate time.
Any organisation responsible for all or part of the enquiry should have regard to their other responsibilities or legal powers in relation to employment law, criminal law and clinical governance. The person identified to undertake the enquiry will be designated as the ‘investigating officer’ for the purpose of the safeguarding adults process. A decision must be made about who will receive all information and any reports that are subsequently produced.
Always consider and reach agreement on the following areas:
Remember to ensure that the desired outcomes of the adult are part of the discussion
The primary focus of the strategy meeting or discussion is the adult. Therefore it may be necessary to hold a separate multi-agency meeting to meet the needs and address the behaviour of the person alleged to be causing the harm. Whether or not this is the case the initial meeting must cover the following issues.
If a decision is taken at the strategy stage to continue with an enquiry under the procedures, agreement should be reached on the following areas:
Other enquiries and processes could be triggered by a safeguarding referral. Different situations can be risk assessed and investigated by various agencies, and these should be clearly agreed at the strategy discussion/meeting.
See also Information Sharing
A record should be made of the decisions and actions agreed.
Minutes of the meeting will be distributed within agreed timescales at the meeting. Regard should be given to confidentiality and data protection issues.
The information should not be shared for any purpose other than the protection and care of the adult/s at risk of abuse and / or neglect. Ownership of all documentation in relation to the enquiry sits with the agency leading the enquiry; agreement should be sought in relation to wider information sharing.
When an employer is aware of abuse or neglect in their organisation, then they are under a duty to correct this and protect the adult from harm as soon as possible and inform the local authority, Care Quality Commission and the local clinical commissioning group. The local authority has a duty to make whatever enquiries it deems necessary to decide what if any action needs to be taken and by whom. The local authority may well be reassured by the employer’s response so that no further action is required. However, the local authority must be satisfied that the employers response has been sufficient to deal with the safeguarding issue and, if not they will undertake an enquiry of its own and take any appropriate follow up.
Duty of Care is defined simply as a legal obligation to:
When acting in an adult’s best interests staff must do so with the adult’s consent unless they have evidence that the person lacks capacity to make that particular decision at the time it needs to be made.
In the following situations, action should be taken under the safeguarding adults procedures even if the adult does not want any action taken. The adult should be informed of the decision, the reason for it and be reassured that wherever possible no actions will be taken which affect them personally without their involvement:
See also Mental Capacity and Deprivation of Liberty Safeguards and Consent.
Where there is concern that the adult may not have mental capacity to make relevant decisions, it is important that their capacity is appropriately assessed as soon as possible. It may be established that, with appropriate support, they are able to make their own decisions.
If it is established that the adult lacks capacity, feedback will be given to them and anyone who is acting in their best interests (for example, their attorney or court appointed deputy), unless they are implicated in the allegation.
If the person has no suitable family or friend who can be consulted regarding their best interests, an advocate or an Independent Mental Capacity Advocate (IMCA) should be instructed in line with the local IMCA referral policy. An IMCA may be instructed if it is thought that it will be beneficial to the adult, even if they have family, friends and carers available to consult (see also Advocates).
The managing officer must ensure that contact is made with a carer or personal representative. The managing officer will also decide in consultation with other relevant organisations what will be fed back at this point to the person causing the harm.
If the adult has mental capacity to make decisions about their safety, consideration must be given to:
Allegations of abuse made by service user’s family members, friends and neighbours should be investigated without prejudice. However, where repeated allegations are made and there is no foundation to them and further Enquiry is not in the best interests of the adult, then local procedures apply for dealing with multiple, unfounded complaints.
The large scale investigation process is usually triggered when there are significant concerns and / or high levels of safeguarding activity within a particular setting or organisation which is providing services to adults.
The process is a coordinated multi-agency response designed to protect service users and ensure that any significant issues raised with a particular care provider are appropriately addressed.
The large scale investigation process is not a replacement for individual safeguarding alerts and enquiries.
The strategy discussion or meeting is, where appropriate, a multi-agency discussion between relevant individuals involved in order to share information, plan and agree how to proceed with the enquiry, considering all the known facts. It can be face to face or by telephone.
The purpose of the strategy discussion or meeting is:
The lead agency should ensure that a strategy discussion or meeting takes place involving appropriate agencies, and that this is recorded and decisions are circulated. The chair should be an appropriate manager, how senior the manager is required to be may depend on the nature of the inquiry, such as how large scale this may be. The meeting / discussion should also identify any support to be given to the investigating officer or team by staff from other agencies (for example, tissue viability nurses, police, housing, service provider).
An agreement must be reached at the meeting about the respective roles and responsibilities of organisations during the enquiry in terms of lead responsibilities, specific tasks, cooperation, communication and the best use of skills.
Where there is or is likely to be a criminal investigation there should be discussion with the police at the earliest opportunity and coordination of processes to avoid prejudicing such investigations.
If there is going to be a police investigation that could lead to criminal proceedings, there should be early identification of the likely need for witness support and special measures made available to witnesses as required (see Safeguarding Adults – Witness Support).
If there are going to be a number of enquiry / investigation processes being undertaken, the meeting or discussion will decide in what order the various processes should take place.
Where joint enquiries or assessments are planned, there should be clear agreement between the organisations concerned as to their respective roles and responsibilities.
Non-police enquiries should always be led by a suitably experienced and competent worker.
It is the responsibility of the lead agency where the alleged abuse occurred to coordinate the enquiry process to avoid any duplication of work within the enquiry. Different types of enquiries may be undertaken simultaneously, therefore all staff leading these enquiries must keep in regular contact to ensure that one enquiry does not impact or interfere with any other.
No individual agency can delegate their statutory responsibility to another. Each agency must act in accordance with its duty of care to safeguard adults when it is satisfied that action is appropriate.
Agencies will have their own operational policies and internal procedures applicable to their staff, which should be read in conjunction with these procedures.
The managers within the lead agency are responsible for conducting safeguarding enquiry. The manager will ensure that:
The manager should agree the accuracy of all records relating to a safeguarding adults enquiries / assessment, including records of:
The investigating officer should be a suitably experienced and competent member of staff working under the supervision of a manager. Care must always be taken to ensure complete independence of the investigator from the adult and the person alleged to have caused harm. The investigating officer is responsible for leading and coordinating the safeguarding enquiry / assessment in line with the agreed decisions made at the strategy discussion / meeting. The enquiry should involve:
Adults who are experiencing or at risk of abuse and neglect, are entitled to the protection of the law in the same way as all. Behaviour which amounts to abuse and neglect, for example assault and physical, sexual or psychological abuse, theft and fraud and certain forms of discrimination may also constitute specific criminal offences. If a local authority, other agency or individual believes that a criminal offence may have been committed then it must refer it to the police urgently.
Whether or not a criminal act is committed does not depend on the consent of the victim. Criminal investigation by the police takes priority over all other enquiries but not over the adult’s wellbeing. Close cooperation and coordination among the relevant agencies is critical to ensure safety and wellbeing is promoted during any criminal investigation process.
When the interview involves a suspect who is equally vulnerable, then there is an obligation to provide an Appropriate Adult.
If there is a possibility of criminal proceedings, it is important that repeat interviews are avoided as evidence can become contaminated. In such cases the police will direct any disclosure interview/s.
The interview should be planned in advance and a record made of the plan.
Achieving Best Evidence guidance, and the Youth Justice and Criminal Evidence Act 1999 (special measures) detail special measures which apply to vulnerable adults as victims. There are measures available to people under 18 years of age when giving evidence or information for the purpose of a criminal investigation.
Each organisation must designate a suitably experienced and competent member of staff to ensure that it carries out its role and responsibilities in the plan as agreed at the strategy stage. This will include ensuring that the organisation carries out agreed actions within agreed timescales.
In addition the designated manager in each organisation will ensure that:
– End –