The Care Act 2014
Sections 42 to 47 of the Care Act 2014) set out the main duties relating to safeguarding adults at risk of abuse or neglect:
- 42 - Enquiry by local authority
- 43 - Safeguarding Adults Boards
- 44 - Safeguarding adults reviews
- 45 - Supply of information
- 46 - Abolition of local authority's power to remove persons in need of care
- 47 - Protecting property of adults being cared for away from home
The Care Act is supported by the "Care and Support Statutory Guidance" (the Guidance).
Chapter 14 of the Guidance provides detailed guidance on sections 42 to 47 of the Care Act and covers:
- Adult safeguarding: what it is and why it matters
- Abuse and neglect
- Understanding what they are and spotting the signs
- Reporting and responding to abuse and neglect
- Carers and adult safeguarding
- Adult safeguarding procedures
- Local authority's role and multi-agency working
- Criminal offences and adult safeguarding
- Safeguarding enquiries
- Safeguarding Adults Boards
- Safeguarding Adults Reviews
- Information sharing, confidentiality and record keeping
- Roles, responsibilities and training in local authorities, the NHS and other agencies
Co-operation is at the heart of the safeguarding process and a number of duties are imposed under the Care Act the principal ones being:
- 3 - Promoting integration of care and support with health services etc.
- 6 - Co-operating generally
- 7 - Co-operating in specific cases
Chapter 15 of the Guidance provides guidance on sections 3, 6 and 7 of the Care Act.
Section 6(6) of the Care Act provides that the local authority must co-operate in the exercise of its functions for the purposes of promoting wellbeing, improving quality of care, smoothing the transition from children to adult services, safeguarding and case reviews.
Section 7 of the Care Act provides that where a local authority requests the co-operation of a relevant partner (or a local authority which is not one of its relevant partners) in the exercise of its functions under Part 1 of the Care Act the partner or authority must comply with the request unless it considers that doing so would be incompatible with its own duties, or would otherwise have an adverse effect on the exercise of its functions. Section 7(2) provides that it is a reciprocal function i.e. each must co-operate with the other.
Relevant partners of a local authority include any other local authority with whom they agree it would be appropriate to co-operate (for example, neighbouring authorities with whom they provide joint shared services) and the following agencies or bodies who operate within the local authority's area including:
- NHS England
- NHS Integrated Care
- NHS trusts and NHS foundation trusts
- Department for Work and Pensions
- Probation services
Local authorities must also co-operate with such other agencies or bodies as it considers appropriate in the exercise of its adult safeguarding functions, including (but not limited to) those listed in section 6(3) Care Act:
- General practitioners
- NHS hospitals
- Housing providers
- Health providers
- Care providers
Section 45 Care Act concerns the supply of information between agencies. Chapter 14 of the Guidance includes guidance on information sharing and confidentiality. Of particular importance:
- Early sharing of information is the key to providing an effective response where there are emerging concerns
- To ensure effective safeguarding arrangements all organisations must have arrangements in place which set out clearly the processes and the principles for sharing information between each other, with other professionals and the Safeguarding Adults Board (SAB); this could be via an Information Sharing Agreement to formalise the arrangements.
- No professional should assume that someone else will pass on information which they think may be critical to the safety and wellbeing of the adult.
- If a professional has concerns about the adult's welfare and believes they are suffering or likely to suffer abuse or neglect, then they should share the information with the local authority and, or, the police if they believe or suspect that a crime has been committed.
- In order to respond appropriately where abuse or neglect may be taking place, anyone in contact with the adult, whether in a volunteer or paid role, must understand their own role and responsibility and have access to practical and legal guidance, advice and support. This will include understanding local inter-agency policies and procedures.
- In any organisation, there should be adult safeguarding policies and procedures. These should reflect this statutory guidance.
- Local authorities must cooperate with each of their relevant partners, as described in section 6(7) of the Care Act, and those partners must also cooperate with the local authority, in the exercise of their functions relevant to care and support including those to protect adults.
- Agencies should stress the need for preventing abuse and neglect wherever possible.
- Partners should ensure that they have the mechanisms in place that enable early identification and assessment of risk through timely information sharing and targeted multi-agency intervention.
- In order to carry out its functions, SABs will need access to information that a wide number of people or other organisations may hold.
With regard to confidentiality:
- Agencies should draw up a common agreement relating to confidentiality and setting out the principles governing the sharing of information, based on the welfare of the adult or of other potentially affected adults
- Any agreement should be consistent with the principles set out in the Caldicott Review published 2013 ensuring that:
- information will only be shared on a 'need to know' basis when it is in the interests of the adult
- confidentiality must not be confused with secrecy
- informed consent should be obtained but, if this is not possible and other adults are at risk of abuse or neglect, it may be necessary to override the requirement
- it is inappropriate for agencies to give assurances of absolute confidentiality in cases where there are concerns about abuse, particularly in those situations when other adults may be at risk
- Where an adult has refused to consent to information being disclosed for these purposes, then practitioners must consider whether there is an overriding public interest that would justify information sharing (for example, because there is a risk that others are at risk of serious harm) and wherever possible, the appropriate Caldicott Guardian should be involved. Confidentiality: NHS Code of Practice sets out guidance on public interest disclosure.
- Decisions about who needs to know and what needs to be known should be taken on a case by case basis, within agency policies and the constraints of the legal framework
- Principles of confidentiality designed to safeguard and promote the interests of an adult should not be confused with those designed to protect the management interests of an organisation. These have a legitimate role but must never be allowed to conflict with the welfare of an adult. If it appears to an employee or person in a similar role that such confidentiality rules may be operating against the interests of the adult then a duty arises to make full disclosure in the public interest
- In certain circumstances, it will be necessary to exchange or disclose personal information which will need to be in accordance with the law on confidentiality and the Data Protection Act 1998 where this applies. The Home Office and the Office of the Information Commissioner have issued general guidance on the preparation and use of information sharing protocols. Information for staff, people who use care and support, carers and the general public
It is important that professionals engaged in safeguarding work are fully aware of where to turn to get expert advice and assistance related to a specific area of an individual's life. Advice and assistance can be sought from a number of agencies on a range of matters including:
Criminal offences - the involvement of the Police in investigations gives first hand advice and guidance on potential criminal offences. Referral through the Public Protection Unit at Swinton Police Station continues to be the main link with the Greater Manchester Police Service.
- Provision of care - Investigations of standards and breaches of regulations in services regulated by the Care Quality Commission.
- Benefit issues - discuss with the local office of the Department of Works and Pensions.
- Mental health issues - concerns for individual's mental wellbeing - refer to local mental health services, in particular, Approved Mental Health Practitioners, for advice on engaging with processes under the Mental Health Act 1983.
- Employment law - contact relevant Human Resource services for advice and support. Private and other non-statutory providers of services may have access to their own employment legal advice.
- Equalities - contact your Equalities Team or the government advice line, the Equality Advisory and Support Service
- Access to people & property - the police may have a power of entry to property to gain access to individual's property which concerns have been raised about - liaise with the police. (Refer to local organisation policies on issues such as non-access visits by care agencies or professional staff).
In complex situations it may be necessary to seek legal advice and guidance on specific adult safeguarding issues.
The SAB may seek advice from the Shared Legal Service, a service that provides advice to Salford and Manchester City Councils. Individual agencies will need seek advice from their own legal representatives or advisers.
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