July 2015: This chapter has been revised to include conference report forms for agencies and GPs (see Appendix 1).
A case conference is a multi-agency meeting held to discuss the outcome of the safeguarding enquiry, agree conclusions and to decide whether it is necessary to put in place a long-term protection or safety plan. Wherever possible the adult who is experiencing or at risk of abuse or neglect should be invited to, supported at and enabled to attend the case conference.
A manager from the lead agency should ensure that a case conference is convened, chaired and minutes taken (see local guidance for chairing arrangements).
In large scale enquiries a more senior / independent person may take the chair. The investigating officer will submit a report summarising the findings of the enquiry / assessment and will attend the case conference. Any reports made to date will be available to the meeting and will form the basis of discussion. Confidentiality arrangements relating to the reports should be clearly defined by the chair. Reports should not be shared with people who did not attend the conference without express permission of the chair.
Wherever possible the adult should be involved and assisted to participate in the case conference. It is essential that the adult is given information about the purpose of the conference in advance, and who will be there. In some cases, in order to meet the access and communication needs of the adult (for example if specialist facilities are needed), a separate protection plan meeting could be held in a different venue. Such a meeting should be held on a date as close to the case conference as possible.
In some cases the conference will be divided into two parts where:
In such cases the first part of the meeting is attended by professionals only, and the adult and/or their representative will attend the second part. Alternative arrangements may also need to be considered if there has been a large scale investigation involving a number of adults at risk.
If any relevant professional is unable to attend, they must provide their contributory information in writing to the meeting.
All those attending should have the delegated authority to agree to make decisions about the provision of resources and services that will contribute to the protection plan.
The adult should be:
If the adult has capacity to make decisions about their own safety, their views should be taken into account about:
If the adult has mental capacity but does not wish to attend the case conference, they should be consulted beforehand about their views and these should in turn be given at the meeting by a representative, advocate or key worker.
If the adult does not have capacity a decision needs to be made about who the key decision-makers should be, in line with the MCA Code of practice.
The meeting should be held at a venue which enables the adult to fully participate. In some cases this may be in their own home.
If the adult does not attend the meeting the reasons for this should be recorded.
The meeting should decide and record:
Family members do not have an automatic right to attend a case conference and should only be invited at the express wish of the adult if deemed appropriate If the adult does not have capacity to make that decision, it may be made in their best interests, or with the consent of a Lasting Power of Attorney or Deputy appointed by the Court of Protection.
The case conference will:
The fact that there is insufficient evidence for a criminal prosecution does not necessarily mean that action cannot be taken under civil proceedings (for example seeking an injunction) or disciplinary proceedings, because there are differing burdens of proof. Discussions about this may form part of the case conference, although final decisions may be made at a later date (e.g. it may not be possible to state with certainty that civil proceedings will take place or the final outcome of disciplinary investigations).
The safeguarding adults protection plan aims to remove or minimise risk to the person and others who may be affected, if it is not possible to remove the risk altogether. It will need to be monitored, reviewed and amended as circumstances arise and develop. Those attending the case conference will:
The protection plan will not include actions taken against the person causing harm. Protection plans are case specific but are likely to include:
It is imperative that practical steps are taken to ascertain the wishes and views of the adult in relation to the protection plan.
Normally a protection plan will be agreed as part of the case conference. However, a separate protection plan meeting may be considered necessary if:
Supporting the person to make decisions about what can be done to help them will mean that they are given information about:
The individual should also be offered the options of:
A referral to the DBS must be made by the regulated activity provider:
Other potential outcomes are:
In addition, organisational changes may be implemented following a review (for example to staffing, recruitment, training, working practices and culture, improvement of risk monitoring and quality assurance). Changes may also be made in response to recommendations from any complaints process. Such changes can include the setting up of an Safeguarding Adult Review or serious incident process if there are concerns about the safeguarding adults process and / or interagency working by partners.
See also Information Sharing.
Where concerns have been identified about the quality of care from a particular provider, following the enquiry:
A report that is available to the public is produced annually to demonstrate the Safeguarding Adults Return (SAR) which is a mandatory collection that records information about individuals for whom safeguarding referrals were opened during the reporting period (also referred to as adults at risk) and case details (also referred to as allegations) for safeguarding referrals which concluded during the reporting period. The purpose of the collection is to provide information which can help stakeholders to understand where abuse may occur and improve services for individuals affected by abuse.
The SAR data is recorded by adult safeguarding teams based in the 152 councils with Adult Social Services Responsibilities in England. At the end of the reporting year these data are submitted to the Health and Social Care Information Centre (HSCIC) in an aggregate form through Omnibus, a secure online data collection system.
Staff must keep records in keeping with their organisational guidelines / processes.
Minutes should be recorded on the relevant local authority or agreed multi-agency pro forma and approved by the chair of the meeting. The minutes record the decisions of the case conference and evidence of how the decisions were reached. This may involve recording separate decisions and outcomes for each allegation.
The minutes should be circulated within agreed timescales to:
Unless this would increase the levels of risk, a copy of the protection plan should be sent to the adult or, with their permission, to another person. If the adult does not have mental capacity, a decision should be made in their best interests about to whom to send the minutes. If the adult has attended the case conference then the minutes will be shared with them subject to an assessment of risk. Where there is information that cannot be shared, it should be deleted from any documents sent out. It is imperative that Data Protection Act 1998 principles are adhered to.
Where information is sent to a carer, with permission of the adult or in their best interests, the managing officer will decide what information can be shared about the person causing the harm.
Whether or not minutes of the meeting are sent to the adult, the managing officer will decide the most appropriate person to report back the outcome of the meeting. This should take place as soon as possible after the meeting. The adult should be enabled to raise any issues they may have about the decisions taken and the protection plan that has been developed and agreed upon.
Feedback should also be given to the person who made the referral, taking into account confidentiality and data protection issues.
A decision must be made at the meeting about what feedback should be provided to the person alleged to be causing harm and the organisation that employs that person (if relevant), and who should provide it. If the person alleged to be causing the harm does not have mental capacity (and is also an adult at risk), feedback will be given using the support of the person acting in their best interests.
Click here to view Agency Report Form for Safeguarding Adults Case Conference
Click here to view GP Report Form for Safeguarding Adults Case Conference
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