Trafford Multi-Agency Safeguarding Adults Policy and Procedures
Trafford Safeguarding Adults Board
January 2017
Foreword
I am pleased to endorse the revised Multi-Agency Policy and Procedures for Adult Safeguarding in Trafford.
Adult Safeguarding is everyone's concern, and when safeguarding concerns arise, it is critical that we all know what we need to do. This policy and procedures will help ensure that we keep the person at risk at the centre of all we do. They will support staff who work with vulnerable people to provide the best service they can, and they will assure everyone in Trafford that all safeguarding concerns will be responded to in a professional and timely way, and so will help protect vulnerable members of our community.
I wish to thank all those who have worked on revising these procedures, along with all the staff who work so hard when faced with issues of adult abuse, whose commitment and enthusiasm ensures adult abuse remains a key priority for all agencies across Trafford.
Maureen Noble
Independent Chair of Trafford Safeguarding Adults Board
The NHS Commitment in Trafford
The NHS Commitment in Trafford encompasses:
- The prevention of harm, exploitation, neglect and abuse through the commissioning provision and delivery of high quality NHS services
- Effective, proportionate responses to allegations of harm, exploitation, neglect and abuse that are set out in multi –agency procedures
- Learning from adult safeguarding which improves safeguarding for our patients
- Contributing and actively engaging as part of a multi-agency safeguarding partnership
The commissioning and delivery of high quality health care for patients is at the heart of the NHS Trafford CCG and across Greater Manchester.
The NHS providers serving Trafford are committed to offering support and protecting those who find themselves in the most vulnerable situations, whilst at the same time supporting adults at risk to keep control of their lives and make informed decisions wherever this is possible
Trafford’s revised Safeguarding Adult Multi-Agency Policy and Procedures will support staff, practitioners, managers and leaders of the local health services to meet their responsibilities in regard to those adults deemed to be at risk; they strengthen the multi-agency partnership that exists within Trafford and across Greater Manchester.
Catherine Randall
Chief Nurse / Head of Safeguarding
NHS Trafford Clinical Commissioning Group
Greater Manchester Police Trafford Division
Greater Manchester Police in Trafford, and across Greater Manchester, are working closely with Local Authority Adult Social Services, Commissioners and service providers, the Care Quality Commission and others to safeguard adults at risk from harm, exploitation and abuse, ensuring the safety and protection of the most vulnerable people in our communities.
Working with partner agencies to target offenders and support victims is a key aspect of our approach to dealing with adults at risk. This approach is supported through the implementation of local police Public Protection Investigation Units, who will liaise with partner agencies, monitor investigations and provide advice.
In recent years, several serious incidents have demonstrated the need for immediate action to ensure that adults who are at risk of abuse or who have been abused receive care, protection and support. In particular, a range of public inquiries have identified that ‘greater information sharing and multi-agency working may have placed organisations in a more positive position to safeguard adults concerned’.
These revised Multi-Agency Safeguarding Adults Policy and Procedures establish a tight framework through which Greater Manchester Police officers and staff will engage with partner agencies and where crimes have been committed, investigate, ensuring that all adults at risk are fully supported in accessing equal criminal justice opportunities, whilst considering the continued health and social care needs of the victim.
Jim Liggett
Divisional Superintendent
Greater Manchester Police
Trafford Division
Pennine Care NHS Trust and Trafford Council
These revised Multi-Agency Safeguarding Adult Policy andProcedures reflect the commitment of Trafford Council/Pennine Care Foundation Trust and our partner agencies in Trafford to work together to protect people from abuse and harm. The procedures will support our work to ensure that people can expect to live a life that is free from harm and where abuse occurs,this is reported andresponded to quickly and effectively.
In April 2015, the implementation of the Care Act 2014 replaced the No Secrets Guidance. These revised procedures reflect learning from the first 12 months of the new legal requirements of the Care Act and are aligned to this legislation. Safeguarding means protecting an adult’s rights to live in safety; free from abuse and neglect. We can only achieve this by working together with our partner agencies and the wider public to both prevent and minimise risks. We have to ensure that the adult’s wellbeing is at the heart of any intervention and includes having regard to their views, feelings and beliefs, as far as we are able, when deciding what course of action to take.
The principle of wellbeing is integral to the revised procedures and we recognise that people may have lives that are complex. Professionals will work with individuals to establish what being safe means to them and how we can achieve the best person centred outcomes for them, taking into account our statutory requirements.
Diane Eaton
Director of Integrated Services
Pennine Care NHS Foundation &Trafford Metropolitan Borough Council
Contents
Foreword
The NHS Commitment in Trafford
Greater Manchester Police Trafford Division
Pennine Care NHS Trust and Trafford Council
1. Introduction
2. Context
2.1 Care Act 2014
2.2 Promoting Wellbeing
2.3 Principles of Safeguarding
2.4 Values - Working together to support adults at risk of abuse and neglect
3. Safeguarding
3.1 What is Safeguarding?
3.2 Aims of Safeguarding
3.3 Preventing abuse and neglect
3.4 Raising awareness
3.5 Providing information and advice
3.6 Who does safeguarding apply to?
3.6.1 Prisoners and persons in approved premises
3.6.2 Personal budgets and self-directed care
3.7 Safeguarding Children
3.8 Transition
4. Abuse and Neglect
4.1 Types of abuse and neglect
4.1.1 Physical abuse
4.1.2 Sexual abuse
4.1.3 Sexual exploitation
4.1.4 Psychological abuse
4.1.5 Financial or material abuse
4.1.6 Organisational abuse
4.1.7 Neglect and acts of omission
4.1.8 Discriminatory abuse
4.1.9 Domestic abuse
4.1.10 Honour- based violence (HBV)
4.1.11 Forced marriage
4.1.12 Female genital mutilation (FGM)
4.1.13 Modern slavery
4.1.14 Human Trafficking
4.1.15 Hate crime
4.1.16 Mate crime
4.2 Who abuses and neglects adults?
4.3 Self-neglect
4.3.1 Hoarding
4.3.2 Responding to self-neglect and hoarding
4.4 Radicalisation and violent extremism
4.4.1 Channel Panel
4.5 Children and young people who abuse
4.6 Abuse by another adult at risk
4.7 Abuse by a person in a position of trust
4.7.1 Disclosure and Barring Service
5. Carers and safeguarding
6. Safeguarding Adult Board’s Overarching purpose
6.1 Develop and publish a strategic plan setting out how they will meet their objectives and how their member and partner agencies will contribute
6.2 The role of the Strategic Board
6.3 The role of board members will be maintain a strategic focus, which includes
6.4 Infrastructure
6.5 Policy Development and Training
6.6 Quality Assurance and Information
6.7 Strategy Development
7. Safeguarding Adult Review (SAR)
7.1 Commissioning Safeguarding Adults Reviews (SARs)
7.2 Raising a SAR
7.3 How is a Safeguarding Adults Review carried out?
7.4 Safeguarding Adults Review Reports
7.5 Roles and Responsibilities
7.6 Outside of SAR remit
7.7 Links with other reviews
7.8 Findings from SARs
8. Mechanisms to support Adult Safeguarding
8.1 Multi-agency public protection arrangements (MAPPA)
8.2 Multi-agency risk assessment conferences (MARAC)
8.2.1 Referral to MARAC
8.2.2 DASH Risk Assessment / Checklist
8.2.3 Independent Domestic Violence Advisor (IDVA)
8.3 Trafford Adults at Risk Group (TARGet)
8.4 Criminal offences and police involvement
8.4.1 Vulnerable and intimidated witnesses
8.4.2 Special Measures
9. Mental Capacity and consent
9.1 Capacity
9.1.1 Assessing Capacity
9.2 Best interests
9.3 Acts in connection with care or treatment
9.4 Advance decisions to refuse treatment
9.5 Lasting Powers of Attorney, Court Appointed Deputy, Court of Protection and Office of the Public Guardian
9.5.1 Abuse by an attorney or deputy
9.6 Independent Mental Capacity Advocate (IMCA)
9.7 Ill-treatment and wilful neglect
9.8 Deprivation of Liberty Safeguards (DoLS)
9.8.1 Restraint and restrictions
9.8.2 Revised test for deprivation of liberty
9.8.3 Identifying deprivation of liberty
9.8.4 Authorising deprivation of liberty
10. Independent advocacy
10.1 Judging ‘substantial difficulty’
10.2 Appropriate Individual
10.3 When to provide advocacy
11. Making Safeguarding Personal
12. Managing risk
12.1 Identifying risks
12.2 Risk assessment
12.3 Reviewing risk
12.4 Risk disputes
13. Information sharing
13.1 Duty to co-operate
13.2 Information sharing
13.2.1 Sharing information with the safeguarding adults board
13.3 Record keeping
13.4 Confidentiality
14. Safeguarding training for staff and volunteers
15. Context
15.1 Feedback
15.1.2 Feedback to people alleged to have caused harm
15.2 Dealing with repeat allegations
15.3 Dispute resolution and escalation
15.4 Cross-boundary and inter-authority concerns/enquiries
16. The 6 Stage Process
16.1 What is a safeguarding adult concern?
16.2 Responsibilities of the person identifying harm, abuse or exploitation
16.2.1 Taking immediate action
16.2.2 Evidence gathering and victim care
16.2.3 Responding to an adult at risk who is making a disclosure
16.2.4 Considering the person alleged to have caused harm
16.2.5 Making a written record
16.2.6 Informing the relevant person that abuse or harm has occurred
16.3 Responsibilities of the manager/safeguarding lead of the person identifying harm, abuse, neglect or exploitation
16.4 Decision Making: Factors to consider when considering making a referral
16.5 What is a referral?
16.6 Where to refer to and how to make a referral
16.7 Contacting the Police
16.8 Screening referrals for Adult Safeguarding
16.9 Receiving a referral and checking the information
16.10 The Trafford Emergency Duty Team
16.11 Decision to move to the Planning Phase
Related documents
16.13 Purpose of the Planning Discussion or Meeting
16.14 Who should attend a Planning Meeting?
16.15 Supporting the adult at risk
16.16 Supporting the person allegedly causing harm
Related documents
16.17 Purpose of the enquiry
16.18 Contributing to other lines of enquiry
16.19 Standard of proof
16.20 Who should carry out an enquiry?
16.21 Roles and responsibilities
16.21.1 Adults Safeguarding Coordinator (Locality Team Senior Practitioner)
16.21.2 Safeguarding Enquiry Lead
16.21.3 The Provider / Partner Agency enquiry lead
16.22 Responsibilities to the adult at risk during the Enquiry
16.23 Undertaking the enquiry
16.23.1 Initial action and decision making under s42:
16.23.2 Dealing with historic allegations of abuse or where the adult is no longer at risk.
16.24 Causing Enquiries by others
16.25 Timescales
16.25 The enquiry lead’s report
16.26 Sharing of the enquiry outcome report
16.27Criminal Investigation
16.28 The Risk Management response (Other safeguarding)
16.28.1 Possible “Other Safeguarding” actions
16.28.2 Recording ‘Other Safeguarding Enquiry’ on LAS
Related documents
16.29 Evaluate Enquiry Outcome and Protect
16.29.1 Managing and evaluating the enquiry
16.29.2 Evaluation / outcomes meeting
16.29.3 Deciding what action is required in the adult’s case, and concluding the adult safeguarding Enquiry.
16.29.4 Possible outcomes for the adult at risk
16.29.5 Possible outcomes for the person alleged to have caused harm
16.30Adults Safeguarding Plan - Overview
16.30.1 Definition
16.30.2 Purpose of the plan
16.30.3 Who should formulate the Plan
16.30.4 Timeliness and risk
16.30.5 Formulating the Plan
16.30.6 The sort of actions to be included in an adult safeguarding Plan
16.31 Safeguarding Adult Plan Review
16.31.1 Closure
Related documents
Section One:Policy
1.Introduction
This multi-agency policy reflects the commitment of all organisations and practitioners in Trafford to work together to safeguard adults at risk.It is based on a shared view across the region of the principles that underpin the Care Act 2014; those of promoting wellbeing and putting service users at the centre of all adult safeguarding by making it personal to each individual.
It aims to provide a structure to enable all agencies to work in partnership with adults, their carers and our local communities to:
- Protect and empower those at risk from being harmed, abused, exploited or neglected
- Safeguard people in a way which supports them to have choice and control about how they want to live
- Safeguard and protect people in a way that focuses on improving their life and wellbeing and supports them to achieve the outcomes they choose
- Respond sensitively and consistently to reported incidents of self-neglect and abuse
- Put in place plans to protect and assist the adult at risk in the best way for them
- Support carers who may themselves be vulnerable or at risk
- Provide a clear process for all staff including those who work in all providerorganisations so that all staff and volunteers are clear about their role and responsibilities in the protection of the vulnerable people with whom they work
- Ensure regular monitoring is in place when concerns have been raised
- Raise public awareness so that communities are supported to contribute in preventing, identifying and responding to abuse and neglect
- Ensure that information is available which is accessible in ways that helps people:
- understand the different types of abuse and enables people to support themselves to stay safe,
- understand how and where to raise concerns about themselves or other individuals
All organisations involved inAdult Safeguarding are asked to adopt this Policy and Procedures in respect of their relevant roles and functions. Each agency must also have its own local operational safeguarding guidance that maps to this Borough Wide procedure. Agencies shouldalso includeany additional internal practice, procedures or protocols as appropriate or relevant to their particular organisations.These Procedures should also be used in conjunction with partnerships and individual organisations’ procedures on related issues such as fraud, disciplinary procedures and health and safety.
This Policy and Procedures should be read in conjunction with the Care Act 2014and The Care and Support Statutory Guidance 2014 Chapter 14 Safeguarding.
2.Context
2.1 Care Act 2014
The Care Act 2014 [hereafter referred to as the Act] came into effect on 1st April 2015. It unites a number of different Acts into one single legislative framework for adults with care and support needs and their carers.
The Act also introduces new duties and requirements of local authorities in a number of areas, including safeguarding adults.It provides, for the first time, a legislative framework for those working in safeguarding adults.
From April 2015 each local authority must:
- Make enquiries, or ensure others do so, if it believes an adult is subject to, or at risk of, abuse or neglect
- Set up a Safeguarding Adults Board (SAB)
- Arrange, where appropriate, for an independent advocate to represent and support an adult who is the subject of a safeguarding enquiry or Safeguarding Adult Review (SAR) where the adult has ‘substantial difficulty’ in being involved in the process and where there is no other appropriate adult to help them
- Cooperate with each of its relevant partners in order to protect adults experiencing or at risk of abuse or neglect
The Department of Health statutory guidance, issued alongside the Care Act – Care and Support Statutory Guidance 2014:Chapter 14 Safeguarding–replaces the No Secrets guidance issued in 2000 (No Secrets: Guidance on Developing and Implementing Multi-Agency Policies and Procedures to Protect Vulnerable Adults from Abuse).
The Act does not allow certain functions to be delegated and safeguarding is one of those functions. Since the local authority must be one of the members of SABs, and it must take the lead role in adult safeguarding, it may not delegate these statutory functions to another party.
The Care Act signals a major shift in safeguarding practice - a move away from a process-led, tick box culture to a person centred approach which achieves the outcomes that people want.
Practitioners are required to focus on adopting approaches and interventions that fit the individual, rather than slotting individuals into a prescribed process.We all have different preferences, histories, circumstances and life-styles, so it is unhelpful to prescribe a single process that must be followed whenever a concern is raised.
2.2 Promoting Wellbeing
The Care Act 2014 introduces a duty to promote wellbeing when carrying out any care and support function in respect of a person. This is sometimes referred to as “the wellbeing principle” because it is a guiding principle that puts wellbeing at the heart of care and support.
The wellbeing principle applies in all cases, where undertaking any care and support function, making a decision on behalf of an incapacitated adult, or safeguarding adult at risk activity. It applies equally to adults with care and support needs and their carers.
Wellbeing is a broad concept, and 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 day-to-day life (including over care and support provided and the way it is provided)
- Participation in work, education, training or recreation
- Social and economic wellbeing;
- Domestic, family and personal relationships
- Suitability of living accommodation
- The individual’s contribution to society
Promoting wellbeing means actively seeking improvements, at every stage, in relation to the adult with care and support needs (regardless of whether they have eligible needs or not) and carers. It is a shift from providing services to the concept of “meeting needs”.
Wellbeing is central to the NHS strategies encompassed within the Compassion in Practice programme and the Ministry of Justice commitment to support victims.
Professionals must work together to ensure that the adult’s wellbeing is promoted throughout the safeguarding process, whilst at the same time having regard to their views, wishes, feelings and beliefs in deciding any action.Professionals and other staff should not be advocating ‘safety’ measures that do not take account of individual wellbeing as defined above.