Chapter 15: Adult Protection Committees
1. The Act creates an obligation on councils to establish multi-agency Adult Protection Committees (APCs). This chapter covers Sections 42 to 47 of the Act which set out the provisions relating to the establishment, composition and functions of these committees. Section 47 requires APCs and councils to have regard to guidance issued by the Scottish Ministers about their functions under Sections 42 - 46, namely:
- information sharing; and
2. The Act provides a framework for how APCs should operate. The intention is that each committee will evolve its own procedures to reflect local arrangements and Ministers will monitor effectiveness through the biennial reporting system.
3. APCs must be established for every council area, although they are not formal committees of the council. There may be different models to deliver this and local authorities should adopt the model that is most appropriate for their area, especially where there are shared boundaries with Health authorities, and to work with Police Scotland. Where an APC covers more than one council area, each authority will remain accountable for the activities in their own council area. Local authorities will need to work together with their partners to ensure APCs work effectively.
4. In summary, Adult Protection Committees (APCs) are responsible for monitoring and advising on adult protection procedures and practice, for ensuring appropriate cooperation between agencies and for improving the skills and knowledge of those with a responsibility for the protection of adults at risk. This includes:
- developing and introducing arrangements and protocols for inter-agency working, and auditing and evaluating the effectiveness of these arrangements;
- developing procedures, policies and strategies for protecting adults at risk and reviewing these;
- developing and introducing arrangements to monitor, review, disseminate and report activity data in relation to the protection of adults at risk;
- raising awareness and providing information and advice to the wider community and to professionals;
- training and development activities;
- improving local ways of working in light of knowledge gained through local and national experience, case review and research; and
- undertaking any other functions relating to the safeguarding of individuals as the Scottish Ministers may specify by order.
5. APCs will need to be given the authority by local agencies to be able to carry out these functions effectively, and will need lines of accountability to local councils, health Boards and Police. To ensure that appropriate authority is delegated, it is good practice for there to be a Chief Officers Group. This would be expected to have a core membership at Chief Executive, Director or Senior officer level from the Council, NHS and Police.
6. APC membership must include representatives of:
- Health Board
- Healthcare Improvement Scotland (HIS)
- the chief constable of Police Scotland
7. The Care Inspectorate may also nominate a representative with appropriate skills and knowledge.
8. All nominees must have relevant knowledge and skill including an understanding of the importance of working collaboratively and effectively in a multidisciplinary and multiagency context. Nominees should be of sufficient seniority to represent their organisations in discussions and decisions about policy, resources and strategy.
9. The council must appoint to the APC anyone nominated by these bodies. The establishment of an APC should therefore be planned in consultation with all of these bodies, and any other partners the council wishes to involve.
10. The Act gives councils discretion to appoint other representatives who can bring particular expertise to the Committee. A wide range of statutory services contribute to the protection of adults at risk. There are important procedural and practice links to be made between adult protection, child protection and the public protection role of criminal justice services. In addition, effective adult protection can only be achieved when it is planned and delivered within the wider context of public protection and community safety. APC's should ensure that their activity and experience is shared across the public protection community, Child Protection, MAPPA, Consumer Protection, Trading standards, Criminal Justice Authorities, and the roles of other agencies and services. This should be in the context of the Guidance on Single Outcomes for Community Planning Partnerships:
11. In considering membership, it will be important to involve and engage with:
- services for adults, children and families
- criminal justice services
- other council services including housing, education and consumer protection
- local community and specialist police
- British Transport Police
- Scottish fire and rescue service
- health services including general practitioners, allied health professionals, acute and psychiatric hospitals and community health services
- the prison service
- procurator fiscal
- Office of the Public Guardian
- the Mental Welfare Commission
- third sector organisations e.g. care providers, carer groups
- independent sector organisations e.g. care providers, the financial sector, independent advocacy organisations
12. The need to support and protect adults at risk extends to adults within managed and registered care services and independent hospitals such as psychiatric hospitals and hospices. Where harm occurs or is suspected in these situations, the Care Inspectorate or HIS has a responsibility through its regulatory functions of inspection, complaints and enforcement. APCs will want to ensure a proper understanding of roles and responsibilities between the Inspectorate, HIS and local agencies through, inter alia further development of existing Memoranda of Understanding, regardless of whether the Care Inspectorate nominate a representative to a Committee.
13. The duties and powers of the Act relate to adults in all settings who are, or may be being harmed. Within NHS services this includes inpatient, day or other services. These situations will involve health service managers and monitoring bodies, particularly NHS Health Improvement Scotland. As with registered care services, APCs will want to ensure the Act's full implementation in relation to these services and ensure adequate representation of the full range of NHS services and monitoring bodies.
14. The Mental Welfare Commission for Scotland (MWC) has particular statutory responsibilities in relation to the care and treatment of people with mental disorders both in monitoring practice and carrying out inspections and inquiries. APCs will also want to ensure that arrangements are agreed and understood about the relationship between local agencies and the MWC in adult support and protection work.
15. Similar understanding will need to be developed with the Office of the Public Guardian.
16. The Act requires that, should they so request it, APCs allow attendance of representatives from the Mental Welfare Commission for Scotland, the Public Guardian and the Care Inspectorate (where it is not already represented on the committee).
17. The Procurator Fiscal Service has a key role in specific APC matters, and it is therefore good practice to invite representatives to meetings dealing with such matters.
18. It is also considered good practice to consider representation from service providers, given their significant role in service delivery.
19. There are important procedural and practice links to be made between adult protection, child protection and the public protection role of criminal justice services. Monitoring and advising on these links will be a function for APCs. Councils and their partners may wish to consider whether these links would be strengthened by representation from child protection and criminal justice on APCs.
Representation of the interests of adults receiving services and carers
20. Each Committee should ensure that their discussion and decisions are fully informed and cognisant of the interests and concerns of local adults at risk and their carers. This may be achieved in a variety of ways.
21. There may be a number of places on the Committee reserved for representatives of adults who have received or might need adult protection services and carers. If this option is chosen, the committee will need to ensure that the full range of groups of adults at risk is represented, and that the Committee procedures, language and agendas are carefully designed to ensure, rather than limit full participation. Every possible means of facilitating participation (such as advocacy, pre-meetings, supporters, interpreting services and the payment of travel expenses) should be considered. Refer to Chapter 5 also.
22. The Committee may establish regular contact with representative groups in their area, and ensure that such contact enables groups to explain their interests and concerns about adult protection as well as to give feedback on the extent to which they feel better protected by the Committees activities. It will be important to ensure that there is contact with the full range of service user groups. It may be necessary and valuable to organise some ad hoc events where there are no established groups. Regular, carefully organised and facilitated events will ensure real exchanges of concerns and opinion.
23. Committees should consider inviting Advocacy and Carer organisations to be represented on the Committee, specifically charged with seeking out and representing the opinions of adults who may need or have needed protecting and their carers. It will be important to ensure that there is an adequate spread of interests represented, and that there is an exchange of information, rather than the Committee seeking feedback on its decisions and agenda.
24. Whichever options are chosen, it will be important for Committees as part of their regular self-assessments to consider whether it is enabling adults at risk to participate 'as fully as possible' in the carrying out of its functions (as required by the principles of the Act).
25. The Act requires the convener to be appointed by, but be independent of, the council. The individual must be seen to be independent in thought and action as well as someone who has the necessary skills and knowledge. It follows from this that it is good practice to appoint a convener who is independent of all bodies represented on the Committee. The council, health board and police should seek to develop arrangements for recruiting to the post of convenor on a collective basis.
26. Some Committees may decide to appoint a vice convenor. Similar principles and criteria could be applied to that appointment.
Procedures and practice
27. The Act allows APCs to regulate their own internal procedures, which should be articulated through governance arrangements that will include terms of reference for the APC and any sub committees.
28. APCs are also expected to ensure that there are robust operational local adult support and protection procedures in place for staff from all agencies. This will be both single- and multi-agency. A list of what these procedures should include can be found Chapter 3.
Joint working, communication and information sharing
29. Any actions undertaken by an APC must have regard to improving cooperation amongst its members. An APC should also have regard to the need for communication and cooperation activities with other APCs.
30. Formal inquiries consistently identify effective communication, information sharing and co-ordination as critical in protecting adults at risk of harm. As well as developing robust information sharing protocols, APCs have an opportunity to provide a model of joint working by the way they themselves operate, and should promote good working relations between agencies and staff working within them. Staff in all sectors will need to understand and accept the absolute necessity of sharing information about adults at risk, and be clear about their roles and responsibilities in supporting those adults.
31. In addition to formal interagency information sharing protocols, adult protection procedures should address arrangements for local interagency and intra-professional communication, recording of actions and interventions, information sharing and coordination. Similar arrangements should be considered between council areas. They should also be clear about expectations in relation to support services such as advocacy and representation for adults at risk, especially where any intervention is pursued under the Act.
32. APCs will also need to ensure that there are effective arrangements in place for resolving disagreements and disputes between agencies about decisions in individual cases and about their roles and responsibilities.
33. The Act requires APCs to give information or advice to its statutory members on the safeguarding of adults at risk present in the council area(s). APCs cannot make decisions about how adult protection will be carried out in practice. Rather, the APC should make recommendations to those bodies, which have formal duties and obligations under the Act. The Scottish Government expects statutory bodies to treat the recommendations of an APC with due regard.
Monitoring, review and reporting
34. APCs should also monitor practice and quality relating to the safeguarding of adults at risk through, for example, regular audits of performance of the agencies in the APC area in relation to adult support and protection. This means that APCs will need expertise in standards of adult support and protection, and to become knowledgeable about local professional practice and performance management.
35. Monitoring and evaluating local practice will involve data collection and data analysis, including the measurement of outcomes. APCs will therefore need to consider what information systems will have to be in place, what form of regular audit is needed, and what research would be helpful. Over time, APCs will then be able to consider practice and performance trends from the information available. This might, for example, include gathering key information relating to:
- numbers of inquiries and investigations;
- the number of adult protection inquiries by age, client group, gender;
- types of harm ;
- involvement of other agencies and users and carers; and
- outcome of referrals and recommendations; and number of and attendance of the adult at risk and other representatives at multi-agency meetings.
36. Each council will be required to complete a data return template from Scottish Government for the Adult support and protection national data set. Committees are recommended to also identify their own information needs and establish systems to meet them.
Individual case reviews
37. The Act does not require APCs to become involved in individual case reviews. APCs have a strategic and monitoring function rather than an operational role and therefore routine case review may well be seen as inappropriate. However, joint consideration of individual cases may help APC members to develop greater joint understanding of service user concerns and professional practice.
38. While there is no duty to do so, APCs are encouraged to evaluate and learn from significant cases or critical incidents: the development of a critical/significant incident and case review procedure, which is endorsed by all the statutory agencies, and interfaces effectively with relevant internal review procedures, is strongly recommended. The national framework for significant case reviews will also be recommended for use when it is published. It is important to ensure that the Committee is regularly appraised of relevant conclusions and recommendation of national Inquiries, reports from the Mental Welfare Commission, for example, to ensure that appropriate lessons and improvements can be adopted in the local area.
39. The Act requires the convener of the APC to prepare a generalreport on the exercise of the committee's functions over the previous 2 years, for approval by the Committee. The report should summarise the work of the APC related to its functions, analyse achievements, identify current issues with services, practice and performance of public bodies and office holders, and set out the required improvements and proposals for future APC programmes. In addition, if the council and its local partners have established terms of reference for APCs which go beyond the requirements of the legislation, they may report on those other matters set out in those terms of reference. The report is therefore likely to address:
- executive summary;
- details of support provided;
- the use of protection orders;
- progress with training;
- communication and cooperation between agencies
- provision of information to the public;
- the management of services and staff/ workforce issues;
- audit and self-evaluation;
- improvements made in last 2 years and improvement action plan for next two years;
- management information on activity, trends, inputs and outcomes in relation to the protection of adults at risk;
40. The Act requires that following approval by the APC, the report must be forwarded to:
- the Council
- the relevant Health Board
- the chief constable of Police Scotland
- Scottish Ministers
- the Mental Welfare Commission for Scotland
- the Public Guardian
- the Care Inspectorate
- any other public body or office holder as the Scottish Ministers may by order specify.
41. APCs will also want to consider how they make the findings set out in the convener's report more widely available within the agencies represented on the committee, to other agencies with a role and responsibilities for the support and protection of adults at risk, to service users and carers and to the general public. APCs will want to consider the issue of publication and the formats in which the report findings are made available.
Improving skills and knowledge
42. APCs have a duty to make or assist in or encourage the making of arrangements for improving the skills and knowledge of the public bodies and office-holders that have responsibilities relating to the safeguarding of adults at risk in their area. A local training strategy will therefore be required recognising the different roles and responsibilities of staff and office holders in statutory, independent organisations. It should address the needs of the following:
- staff working in any sector who need to recognise the signs of harm, neglect or exploitation and require to know when and how to respond;
- staff working in any sector who will be playing a major part in assessments (including risk, capacity and consent), recording events, decision-making on actions to be taken, and involvement in the implementation of protection plans, including legal processes;
- staff managing services who will be supervising others in contact with service users, and who may be involved in decision-making in individual cases and chairing meetings and reviews; and
- staff working in the statutory and legal sectors who will be taking a lead role in legal proceedings in relation to adult protection work
43. APCs should develop a broader communication strategy encompassing general awareness raising and appropriate training for service users, carers and members of the public.