pdated 01/05/2010)
Alert
Staff member alerts the person within their organisation who is responsible for referring to Adult Social care to concerns of abuse or neglect about which they are told, or which they witness.
Referral
Decision by the ‘Referrer’ as to whether they believe there is an allegation of abuse. Contacting the relevant Adult Social Care Department to make a ‘Referral’, unless certain that there is no allegation.
Decision
‘Decision’ by the ‘Safeguarding Manager’ as to whether a Safeguarding Assessment is required and placing the information about the concern into a multi-agency context if required.
Safeguarding Assessment Strategy
Formulation of a multi agency plan to assess the risk, and identify who will undertake the various investigations required (criminal investigation, safeguarding adults investigation, disciplinary investigation etc).
Investigations as Part of the Assessment
Investigations agreed during the Safeguarding Assessment Strategy are carried out by the identified people (criminal investigation, safeguarding adults’ investigation, disciplinary investigation etc).
Safeguarding Assessment
Coordination and collection of information from the various investigations, by the Safeguarding Manager.
Safeguarding Assessment
Evaluating the Safeguarding Assessment and coordinating a multi agency response to the abuse that has been identified. Identifying timescales for a review of the plan.
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1.1 Alerting
The timescale for 'Alerting' is immediately
1.1.1 Alerting occurs when a member of staff is informed, or has concerns, that abuse or neglect has occurred, or is suspected. The member of staff becomes the ‘Alerter’. For example, Alerters might be; care assistants, housing wardens, support workers, community nurses or Police Officers.
When the suspected abuse or neglect of an individual results in death, this multi agency policy, procedures and guidance must still be considered along with any other actions that may be necessary.
1.1.2 Alerters have a duty to share the information with the person within their organisation responsible for referring (and their line manager if this is different), but should not discuss their concerns with anyone else (unless 1.1.3 below applies).
Having a ‘duty to share information’ means; you are not at liberty to keep concerns to yourself and you should never promise to keep secrets. For more information about whistleblowing visit www.pcaw.co.uk
1.1.3 If you feel that you are not able to share information with your manager, the person responsible for referring, or another manager within your organisation, as you believe that they are implicated or colluding with the alleged abuse, you should, in the first instance, follow your organisation’s own ‘Whistleblowing Policy’. If your organisation does not have such a policy or you are unable to follow this because of those implicated in the alleged abuse you should contact the regulatory body (i.e. Care Quality Commission).
1.1.4 If your manager or the person responsible for making a referral makes a decision not to refer and you are unhappy with this decision you still have a duty share information. This should be done by speaking to the next senior person in your organisation.
1.1.5 When acting in the role of Alerter you should:
- Always take any concerns seriously, however insignificant they may seem to you;
- Where the concern comes directly from the vulnerable adult allegedly abused, accept it and avoid making comments other than to comfort or be sympathetic;
- Ensure the immediate safety and welfare of the vulnerable adult allegedly abused. (This may include urgent medical attention);
- Report the concerns urgently to the person within your organisation who is responsible for referring to Adult Social Care (and your manager if this is a different person) - always report, don’t assume someone else already has. If the allegation concerns a member of staff with the responsibility of ‘referrer’, the next senior member of management should be informed;
- State your concerns clearly - don’t use euphemisms;
- Keep a careful, detailed record of the concerns, clearly separating fact from opinion (bear in mind that the record may be required later as part of any legal proceedings). See Record Keeping;
- Follow the Checklist for Alerters
All staff have a duty to report suspicions or disclosures of abuse, and failure to do so is a failure in their duty of care. However difficult it may seem, staff must make known their concerns of abuse.
1.2 Staff who suspect abuse in other organisations
1.2.1 There may be occasions when visiting staff witness or suspect abuse in another organisation (e.g. a district nurse visiting an independent nursing home). In such circumstances the visiting member of staff will be expected to act in the role of Alerter (as above), informing the Manager and the person responsible for Referring (unless 1.2.2 below applies). In addition to this you should inform your own line manager.
1.2.2 If you feel that you are not able to share information with the home manager, the person responsible for referring, or another manager within the organisation, as you believe that they are implicated or colluding with the alleged abuse you should contact the referral point and explain to the call taker that you wish to make a Safeguarding Adults Referral.
1.2.3 If you have concerns about an organisation not amounting to abuse or neglect as described in this document but related to the quality of care being provided you should, in the first instance, report this to the manager of the organisation and your own line manager.
1.2.4 This information should also be passed to the relevant body who commission services from this organisation (for example, local authority purchasing and contracting department) AND the regulatory body (Care Quality Commission).
A process chart has been devised to be used in conjunction with this multi agency Policy, Procedure and Guidance:
Process for the Role of the Alerter [PDF 30KB]
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2.1 Making a Referral
Maximum timeframe for Referral is: Within 24 hours of the Alert being received.
2.1.1 Referring is the responsibility of the nominated person who receives information from the Alerter, as detailed above. This member of staff becomes the ‘Referrer’. For example, Referrers might be; Ward Managers, Care Home Managers, Managers of Home Care Services, Housing Managers or Social Workers. It is important to note here that "Referrers" are not a separate type of staff – referring in this context is simply an aspect of the ‘manager’s’ overall responsibilities.
It is the responsibility of each organisation to have their own internal procedures, which must detail the nominated staff who are able to take on this role. See Internal Procedures.
2.1.2 Before making a referral to the Adult Social Care Department, you should:
- Consider the immediate health/welfare needs of the alleged victim or anyone else who may be affected;
- Consider whether emergency services are required (ambulance, police);
- You should not carry out a formal interview with the alleged victim at this point, however you may need to clarify facts with them.
- Consider whether there is a requirement to inform any regulatory body of the situation such as the Care Quality Commission;
- Gather information to clarify the facts. This will include speaking to the ‘Alerter’;
- Ensure that the ‘Alerter’ and the person who raised the original concern are fully supported;
- Keep detailed records, separating fact from opinion, direct evidence from hearsay (See Record Keeping);
- Inform and seek advice from more senior managers as per your organisation’s own internal procedures;
- Based on the work you carry out and utilising the relevant guidance sections, for example, Possible Indicators of Abuse and Is a referral Required?, make a decision on whether a Referral to the relevant Adult Social Care Department is required. If in doubt, make a referral using the procedure below;
- Follow the Checklist for Alerters
2.2 Making a Referral to Adult Social Care
2.2.1 Once you have gathered the relevant information and established that you believe there is an allegation of abuse, you have a duty to make a referral to the relevant Adult Social Care Department.
2.2.2 Prior to making a referral you will need to gather as much information as you can about the allegation, which you will be asked to provide once you telephone the Adult Social Care Team – you may find it useful to complete Appendix One – Referral Pro Forma, however you do not need to send this anywhere. A full list of the information you will require can be found in Guidance Six - The Referral.
2.2.3 When you have the information, make a referral by contacting either:
This will depend on where the vulnerable adult lives, see Guidance 17 - Inter Authority Arrangements
2.2.4 Explain to the call taker that you wish to make a ‘SAFEGUARDING ADULTS REFERRAL’.
2.2.5 It is important to provide contact details about yourself, as the Safeguarding Manager may need to contact you for further details and, should contact you in any event to offer feedback about the safeguarding assessment.
2.3 Decision NOT to make a referral
2.3.1 If, after assessing all the information available to you and after using Guidance 7 - Is a Referral Required?, you decide that there is no allegation of abuse you do not need to make a referral to the relevant Adult Social Care Department.
2.3.2 You should fully document any such decision and it would be good practice to discuss and agree this action with your line manager.
2.3.3 Any decision not to refer does not mean that the incident should be left or that other actions do not need to take place. Consideration still needs to be given to the needs of the vulnerable adult and to any other actions such as the complaints process, training needs, disciplinary or regulatory action if appropriate.
A process chart has been devised for the role of the referrer. This should be read in conjunction with this Multi Agency Policy, Procedure and Guidance:
Process Referral Chart for the Role of Referrer [PDF 26KB]
3.1 Referral Point
3.1.1 Both Adult Social Care Departments have a referral point that is responsible for receiving safeguarding adults referrals.
3.2 Taking a Referral
3.2.1 When a call is received, the call taker must complete a referral form including the details set out in Guidance Six - The Referral.
3.2.2 The call taker must then use their internal procedures for making the relevant team aware of the referral.
3.2.3 The ‘relevant team’ will usually be the one covering the area of the vulnerable adult’s normal residence. This could be an Assessment and Care Management Team (ACMT), a Community Mental Health Team (CMHT) or a Community Learning Disability Team (CLDT) for instance, depending on the community care group to which the vulnerable person belongs.
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3.3 Safeguarding Manager
3.3.1 The Safeguarding Manager is responsible for making the decision about whether a referral should be dealt with under these procedures.
3.3.2 When a decision is made that a Safeguarding Assessment is required, the Safeguarding Manager is the person responsible for coordinating all of the potential investigations.
3.3.3 The Safeguarding Manager will come from the relevant team within the Adult Social Care Department either in the City or County, or the Healthcare Trust when they have line management responsibility for Integrated Teams.
3.4 The Safeguarding Decision
The timescale for making the ‘Decision’ about whether a safeguarding assessment is required is: By the end of the working day following the one on which the safeguarding adults referral was made
3.4.1 When a referral is received by the Adult Social Care Team, the call taker will instruct the relevant team using their internal procedures.
3.4.2 The Safeguarding Manager will assess the information from the referral and make a decision about whether to accept this and place it formally within the multi –agency context of the Policy and Procedures.
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3.5 Safeguarding Assessment
3.5.1 The Safeguarding Assessment is the coordination and collection of information from the various investigations, by the Safeguarding Manager.
3.5.2 If it is decided that the allegation will be dealt with under this Policy and Procedure, the Safeguarding Manager is responsible for managing the Safeguarding Assessment.
3.5.3 A Safeguarding Assessment Strategy Discussion / Meetingmust be convened, led/chaired by the Safeguarding Manager.
Stress of repeated interviews of a vulnerable adult should be avoided wherever possible and a single interview, if properly planned could fulfil the needs of several investigations. This possibility should be discussed at the strategy discussion.
3.5.4 SAFEGUARDING ASSESSMENTS WILL NORMALLY INCLUDE A SAFEGUARDING ADULTS INVESTIGATION AND AN ASSESSMENT OF THE NEED FOR HEALTH AND SOCIAL CARE PROVISION.
3.5.5 During the Safeguarding Strategy Discussion, any other investigationsrequired should be planned and agreed, for example a criminal investigation, disciplinary or a breach of the Care Standards Act.
3.5.6 A Safeguarding Adults Strategy Plan should be devised and documented detailing all the necessary work which must be completed and by whom.
3.5.7 Any changes to timescales that may affect the Safeguarding Adults Strategy Plan must be reported to the Safeguarding Manager.
3.5.8 After the investigations have taken place, it is normal for a Safeguarding Plan Meetingto be held to consider the outcomes of the various investigations and to compile the Safeguarding Adults Plan, ensuring that any risks are identified, managed and minimised.
3.6 Decision not to place a referral into a multi agency context
3.6.1 When a decision is made not to deal with the referral under the Policy and Procedures, the full reason is documented and feedback is given to the referrer. Whilst discussion should take place and the decision can be questioned, it is the overall responsibility of the Safeguarding Manager to make the formal decision.
PLEASE NOTE: A decision by the Safeguarding Manager NOT to undertake a Safeguarding Assessment DOES NOT mean that other forms of investigation do not need to take place. If appropriate; disciplinary, complaints or regulation inspections should still be undertaken.
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