The Care Act 2014 puts adult safeguarding on a legal footing and requires each local authority to set up a Safeguarding Adults Board (SAB) with core membership from the local authority, the police and the NHS (specifically the local clinical commissioning group). It has the power to include other relevant bodies. 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.
South Tyneside SAB has implemented this procedural framework to ensure consistency across South Tyneside in the way in which adults are safeguarded from neglect or abuse. All organisations involved in safeguarding are asked to adopt this policy and procedures in respect of their relevant roles and functions, but may wish to add local practice guidance, protocols and organisation operation manuals. 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.
2. Principles of Adult Safeguarding
See also Making Safeguarding Personal
The policy and procedures are based on the six principles of safeguarding (see Chapter 14, Care and Support Statutory Guidance ) that underpin all adult safeguarding work. See Safeguarding: What it is and why does it Matter? chapter for more information.
South Tyneside’s multi-agency adult safeguarding policy and procedures are built on strong multi-agency partnerships working together, with adults, to prevent abuse and neglect where possible, and provide a consistent approach when responding to safeguarding concerns. This entails joint accountability for the management of risk, timely information sharing, co-operation and a collegiate approach that respects boundaries and confidentiality within legal frameworks.
3. Risk Management
Safeguarding is fundamentally managing risk about the safety and wellbeing of an adult in line with the six safeguarding principles (see Safeguarding: What it is and why does it Matter?). 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;
- to promote the adoption by all staff of ‘defensible decisions’ rather than ‘defensive actions’.
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 and assessment of risk through timely information sharing and targeted multi-agency intervention. (See (See Managing Risk chapter).
4. Inter-agency Cooperation
Learning from recommendations of Safeguarding Adult Reviews, the importance of effective multi-agency working is a common feature. South Tyneside Council as the local authority, retains responsibility as the lead coordinating organisation. All other relevant organisations and partners however, including the NHS; the Department Work and Pensions; the police and National Offender Management Service and owe legal duties in relation to safeguarding of adults.
Organisations can achieve effective inter-agency working through creative joint working partnerships that focus on positive outcomes for the individual(s). Cooperation 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 South Tyneside’s Health and Wellbeing Board and Community Safety Partnership (see South Tyneside Safeguarding Adults Structures and Organisations).
The local authority and partner organisations should cooperate in order to deliver effective safeguarding, both at a strategic level and in individual cases, where they may need to ask one another to take specific action in that case.
The Care Act 2014 describes a general duty to cooperate between the local authority and other organisations providing care and support. This includes a duty on the local authority itself to ensure cooperation between its adult care and support, housing, public health and children’s services.
It also provides a new ability to request cooperation from a relevant partner or another local authority, in relation to an individual case. The local authority or relevant partner must cooperate as requested, unless doing so would be incompatible with their own duties or have an adverse effect on the exercise of their functions.
If an organisation is refusing to share information, the organisation conducting an enquiry can escalate to the South Tyneside SAB to consider using Care Act 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 sets out five aims of cooperation between partners which are relevant to care and support, although it should be noted that the purposes of cooperation are not limited to these matters. The five aims include:
- 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 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 cooperation or information should provide written reasons for the refusal.
South Tyneside SAB needs to be assured that any shared learning identifies where cooperation has strengthened adult safeguarding and where improvements may be needed, publicising the effectiveness in its annual report.
5. Information Sharing
Sharing the right information, at the right time with the right people, is fundamental to good safeguarding practice, but it has also been highlighted as a difficult area of practice. The Care Act ‘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 legislation (see Data Protection Act 2018 chapter), the Human Rights Act 1998 and the Crime and Disorder Act 1998.
As a general principal people must assume it is their responsibility to raise a safeguarding concern if they believe an adult at risk is suffering or likely to suffer abuse or neglect, and / or are a risk to themselves or another, rather than assume someone else will do so. They should share the information with the local authority and/or the police if they believe or suspect that a crime has been committed or that the individual is immediately at risk.
Helpful guidance is set out in the Caldicott Principles.
Partner organisations may be asked to share information through agreed information sharing protocols. SCIE has produced helpful practice guidance: Adult Safeguarding – Sharing Information
See also South Tyneside SAB’s Information Sharing Protocol.
A duty of confidence arises when sensitive 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 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 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 Act 2018. 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 (see also Mental Capacity).
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.
The Care Act 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. 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 (see Adult Safeguarding Procedures).
The Care and Support Statutory Guidance supports the need for safeguarding to be person led and outcome focused.
“14.14. In addition to these principles, it is also important that all safeguarding partners take a broad community approach to establishing safeguarding arrangements. It is vital that all organisations recognise that adult safeguarding arrangements are there to protect individuals. We all have different preferences, histories, circumstances and life-styles, so it is unhelpful to prescribe a process that must be followed whenever a concern is raised; and the case study below helps illustrate this.
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.”
Wellbeing is a broad concept, and it is described as relating to the following areas:
- 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;
- suitability of accommodation;
- the individual’s contribution to society.
All organisations working with adults who are or may be experiencing or at risk of abuse and neglect, must aim to ensure that they remain safeguarded. This should underpin every activity through consistent safeguarding adults work. This includes any safeguarding activity that is outside the scope of a Section 42 Care Act 2014 enquiry.
Wellbeing is central to the NHS strategies encompassed within the Compassion in Practice programme and the Ministry of Justice Commitment to Support Victims. The wellbeing principle should apply to all agencies involved in safeguarding adults.
8. Organisational learning
It is essential that all aspects of safeguarding practice are monitored and scrutinised on a regular basis. All staff have a responsibility to audit their work.
All agencies need to take responsibility for organisational learning and implement changes to their practice as a result of audits, complaints, Safeguarding Adult Reviews, and most importantly feedback from adults about what works well and what needs to improve. Organisations need to provide opportunities for their staff for learning from themes and patterns of practice that can add value to learning from good practice; pinpointing necessary changes.
In addition to practice guidance highlighted throughout this APPP, see also Adult Safeguarding Practice Questions (SCIE).
South Tyneside SAB expects safeguarding to be given the highest priority across all organisations. There must be a shared value of placing safeguarding within the highest of corporate priorities. Organisations should be judged on the effectiveness of safe communities and their values towards safeguarding adults who may be at risk of, or experiencing abuse or neglect.
These values include:
- 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 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 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 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;
- adults should be given information, advice and support in a form that they can understand and be supported to be included in all forums that are making decisions about their lives. The maxim ‘no decision about me without me’ should govern all decision making;
- all decisions should be made with the adult and promote their wellbeing and be reasonable, justified, proportionate and ethical;
- timeliness should be determined by the personal circumstances of the adult;
- every effort should be made to ensure that adults are afforded appropriate protection under the law and have full access to the criminal justice system when a crime has been committed.