Cases Should Be Referred to the Safeguarding Adults Review Sub Group (SARSG) for Consideration

TSAB Safeguarding Adults Review form

· Cases should be referred to the Safeguarding Adults Review Sub Group (SARSG) for consideration if an adult at risk of abuse or neglect has died or been seriously harmed and abuse or neglect are believed to have been a factor.

· This form should be completed by any professional who has become aware of a case where the above criteria is met.

· All information provided should adhere to information sharing protocols and have due regard to the Mental Capacity Act and Best Interest Decision protocols.

· Please note there is a statutory duty in Section 45 of the Care Act 2014 for agencies to share relevant personal data with the Safeguarding Adults Board.

This form consists of the following colour coded sections:
· Please complete only the section relevant to you
· Please return the whole form to TSAB with remaining sections blank
· Forms should be returned via email to:
Section 1: Referral / To be completed by the referring officer / Page 3 – 6
Section 2: Individual Agency Summary / To be completed by agencies other than the referring agency / Page 7 – 9
Section 3: SACRSG Recommendations / To be completed by the SACRSG / Page 10 – 13
Section 4: TSAB Independent Chair Decision / To be completed by the TSAB Independent Chair / Page 14
To be completed by TSAB Business Unit
Adults Initials:
Date referral received by TSAB: / Date referral sent to Chair of SARSG:
Date individual agency summaries requested: / Deadline for agency return:
Date considered by SARSG: / Date SCRSG recommendations sent to TSAB Independent Chair:
Date of decision by TSAB Independent Chair
SECTION 1 – REFERRAL
To make a referral, please complete Section 1 only
(The objective of this section is to provide as much information that is known at the time of the notification. If information is not available then do not delay in sending in the notification as this information can be submitted at a later stage)
1.1 Referral Details
Date of notification:
Name of referrer: / Role of referrer
Agency: / Address:
Tel No. / Email:
1.2 Adult Details
Forename: / Surname:
Any Know Aliases:
Date of birth: / Date of death (if applicable)
Address:
Gender: / Disability:
Ethnicity: / Faith:
Legal Status of the Adult (Please tick)
Detained under the Mental Health Act / Subject to 117 (Mental Health Act) / Subject to Guardianship
Subject to Deprivation of Liberty / Lasting/Enduring Power of Attorney Registered / Mental Capacity Assessment completed
Legal Status Unknown / Other (please provide details)
1.3 Family composition/significant others
Name / Relationship to adult / DOB / Address
1.4. Agencies known to be involved with the adult (please include names and contact details)
Name / Agency / Contact details / Are they still involved?
1.5. Reason for notification / Yes/No
a) An adult with care and support needs (whether or not those needs are met by the Local Authority) in the Safeguarding Adults Board’s (SAB) area has died as a result of abuse or neglect, whether known or suspected and there is concern that partner agencies could have worked together more effectively to protect the adult
Or
b) An adult with care and support needs (whether or not those needs are met by the Local Authority) in the SAB’s area has not died, but the SAB knows or suspected the adult has experienced serious abuse or neglect and there is concern the partner agencies could have worked together more effectively to protect. In the context of SARs, something can be considered serious abuse or neglect where, for example the individual would have been likely to have died bout for an intervention, or has suffered permanent harm or had reduced capacity or quality of life (whether because of physical or psychological effects) as a result of the about or neglect.
1.6 Types of abuse (Please identify the type(s) of abuse relating to this case (more than one may apply)
Physical Abuse / Modern Slavery / Domestic Violence
Discriminatory Abuse / Sexual Abuse / Organisational abuse
Psychological Abuse / Neglect and actions of omission / Financial or material abuse
Self-Neglect / Serious illness / Other (Please specify)
1.7 Incident Leading to the Referral
Date(s) of Incident / Date of Death of the adult (if different)
Location of Incident:
Please outline events and circumstances which triggered this referral (This is to help establish if the case meets the criteria for conducting a Safeguarding Adults Review and does not need to be detailed analysis of involvement at this stage)
Please continue on a separate sheet if necessary, but please bear in mind that the purpose of the referral is only to determine whether the case meets the criteria for a SAR or other type or review or audit at this stage, so it is suggested that this section should not generally exceed 1-2 pages
The referral is now complete.
Please leave the remainder of the form blank and return the whole form to:
Email:

SECTION 2 – Individual Agency Summary (to be completed by agencies other than the referring agency)
Agency Summary Received
Agency Summary Outstanding

You have been identified as an agency who may have had contact with an adult that will be considered by the TSAB Safeguarding Adults Review Sub Group in order to establish is they should be the subject to a Safeguarding Adult Review

Please check your agency’s records to see if you have had contact with the adult and significant others listed in Section 1 of this form and complete the Individual Agency Summary form below

2.1 Your Details
Name / Role:
Agency: / Tel No / Email
Date Completed
2.2 Declaration of contact
Has the agency named in Section 2.1 (above) had contact with the Adult (or significant others) listed in Section 1 of this form: / Yes/No
(delete as appropriate)
If you have answered No, you do not need to complete further sections and should return the form to XX If you have answered Yes, please completed Table 2.3 below
2.3 Summary of agency contact
Date
Please give date(s) of activity/contact/
Communication / Description of agency activity / contact/communication
It known please provide actual names of staff that are involved in the entry (from whatever agency) as they appear in your records as this will allow identification of the case group. No names will appear in subsequent working papers or reports. / Comments/Analysis
Please provide any additional explanation of your agency’s systems and processes which may be required to understand the entry.
The Individual Agency Summary is now complete.
Please leave the remainder of the form blank and return the whole form to:

Section 3: Safeguarding Adults Review Decision (to be completed by the Safeguarding Adults Case Review sub group)

The form will be completed by a member of the TSAB Business Unit at a SARSG meeting in conjunction with the Chair who will lead the necessary discussions and approve the draft completed form.

3.1 Details of Panel
Date of SARSG: / Chair of SARSG:
Members of SARSG present – please list
Name / Agency
Case discussion: summary of case discussion at SARSG
3.2 Decision/recommendation
Was the SARSG meeting quorate? / Yes / No
Comments:
Does the case meet the criteria for a SAR (Please tick all that apply)
1. An adult with care and support needs (whether or not those needs are met by the Local Authority) in the Safeguarding Adults Board’s (SAB) area has died as a result of abuse or neglect, whether known or suspected and there is concern that partner agencies could have worked together more effectively to protect the adult
Or
2. An adult with care and support needs (whether or not those needs are met by the Local Authority) in the SAB’s area has not died, but the SAB knows or suspected the adult has experienced serious abuse or neglect and there is concern the partner agencies could have worked together more effectively to protect. In the context of SARs, something can be considered serious abuse or neglect where, for example the individual would have been likely to have died bout for an intervention, or has suffered permanent harm or had reduced capacity or quality of life (whether because of physical or psychological effects) as a result of the about or neglect.
And/or
3. The TSAB has discretion to undertake a SAR in other situations where it believes there will be value in doing so. This may be where a case can provide useful insights into the way organisations are working together to prevent and reduce abuse and neglect of adults, and can include exploring examples of good practice.
Or
4. The TSAB can also consider conducting a SAR into any incident(s) or case(s) involving adult(s) at risk of abuse or neglect where it is believed to be in the public interest to conduct such a review.
It was agreed that the case:
(a) Meets the threshold criteria for a SAR / Yes/No
In what ways does it meet the criteria for a SAR?
(please refer to Appendix 1)
(b) Does not meet the threshold criteria for a SAR / Yes/No
In what ways does it not meet the criteria for a SAR?
(please refer to Appendix 1)
Was the recommendation unanimous? / Yes/No
If No, comments/reasons for dissent/who?
3.3 Recommendations for Review/Audit
If this case meets the criteria for a SAR, what type of review methodology should be employed for this review?
· Systems Approach
· SILP
· Hybrid approach
· Other
(if hybrid or other, please provide short commentary)
Review date: From (date): / To (date):
What events should the review concentrate on?
What aspects of the case or key lines of enquiry should the review pursue?
What learning do you expect to gain from the review?
Who should be involved in the review?
Family/Significant Others
Name / Relationship
How will their participation be facilitated?
Agency / Service / Name or Designation (if known)
If the case does not meet the threshold for a SAR, should another type of review be held? Yes/No
If Yes please specify the type of review:
· Partnership Case Review
· Management Review
· Single Agency Individual Management Review
· Warrants a Multi Agency Audit
· Critical Incident Review
· Other (please specify)
Which agency/ organisation should be responsible for discussing TSAB outcome letter with family/significant others?
Agency / Service / Name or Designation (if known)
The SARSG Recommendations will be complete are now complete
The TSAB Business Unit will quality assure the information in conjunction with the sub group Chair and submit the recommendations to the Independent Chair for approval
SECTION 4 Independent Chair Decision
(to be completed by the Independent Chair of the Manchester Safeguarding Adults Board)

The decision in section 3 was discussed by the Safeguarding Adults Review sub group on the DATE and the following has been recommended.

4.1 Decision
My decision is that a Safeguarding Adults Review:
1) should take place for the following reasons:
2) should not take place for the following reasons:
Name
Date
Signed

Appendix One: Criteria for Conducting a Safeguarding Adults Review

The Safeguarding Adults Board has the lead responsibility for conducting an Adult Review.

Section 44 of the Care Act (2014) states:

A Safeguarding Adults’ Board (SAB) must arrange for there to be a review of a case involving an adult in its area with needs for care and support (whether or not the local authority has been meeting any of those needs) if:

a. There is reasonable cause for concern about how the SAB, members of it or other persons with relevant functions worked together to safeguard the adult; and

b. Condition 1 or 2 is met.

Condition 1 is met if:

a. The adult has died; and

b. The SAB knows or suspects that the death resulted from abuse or neglect (whether or not it knew about or suspected the abuse or neglect before the adult died).

Condition 2 is met if:

a. The adult is still alive; and

b. The SAB knows or suspects that the adult has experienced serious abuse or neglect.

A SAB may arrange for there to be a review of any other case involving an adult in its area with needs for care and support (whether or not the local authority has been meeting any of those needs).

A Safeguarding Adults Review is not restricted to occasions where the safeguarding procedures have been followed, and can be applied where this has not been the case.

Adoption of the Safeguarding Adults Review process will be relevant to circumstances where inter-agency working practices have not served to effectively protect the adult(s) at risk from harm or the risk of serious harm.

The Trafford SAB will consider undertaking a Safeguarding Adults Review when it is known or suspected that:

(i) Actions or omissions in a number of agencies involved in the provision of care, support or safeguarding of an adult, or group of adults, at risk of abuse or neglect have caused or are implicated in the death or serious harm of that individual or group of individuals.

(ii) An adult or group of adults at risk die or experience serious harm and there are concerns about how agencies have worked together to prevent, identify, minimise or address that harm and there are concerns about how this may place other adults at risk of serious harm;

And

(iii) There are clearly identified areas of learning and practice improvement or service development that have the potential to significantly improve the way in which adults at risk of abuse and neglect are safeguarded in the future.

The SAR Case Review Sub group of the Trafford SAB will consider the issues raised within the case on behalf of the Trafford SAB, and will carefully examine the potential for learning across agencies/services. It is important that the intensive resources required for an effective Safeguarding Adults Review are only used to ensure the greatest learning and multi-agency practice development for Trafford SAB.