Adult support and protection: learning review guidance

Annex 4

Exemplar Learning Review Report

Core Data – Adult

Adult's Identifier

Age of adult

Gender

Sexual Orientation

Disability

Health needs (including mental health and /or learning difficulties

Education

Living circumstances prior to incident

Position in family/ number of siblings

Ethnicity

Religion

Nature of injury/cause of death

Legal status of adult

Agencies/Services involved

Family/carer factors (if applicable)

Age

Mental health issues

Disability

Health needs (including mental health and/or learning difficulties)

Substance use (if applicable)

Convictions (if applicable)

Problems in childhood (if applicable)

Domestic abuse (if applicable)

Add antisocial behaviour (if applicable)

Ethnicity

Religion

Marital/relationship status e.g. co-habitation

Living circumstances

Agencies/Services involved

Environmental Factors

Financial problems

Housing

Support from extended family/community

Introduction

This includes a brief synopsis the circumstances that led to the review.

The review process

This includes the approach taken to the review, the engagement with the Review Team, details of reviews of records and the compilation of any chronologies, details of any individual meetings with practitioners and managers and of group meetings with practitioners and managers. Details of the involvement of the adult and any family members and carers should also be provided.

The facts

This includes the family background and circumstances, and agency involvement. A succinct chronology or timeline of significant events may also be included if it is essential to an understanding of how learning points were identified. Details of all significant others in the adult's life should also be included.

Analysis

This section critically assesses the key circumstances of the case, the interventions offered, and decisions made. For example, were the family and adult's circumstances sufficiently assessed, were the responses appropriate, were key decisions justifiable, was the relevant information sought or considered, and were there early, effective and appropriate interventions.

Key issues will be identified and the reader should be assisted to understand the 'why' of what happened in the overall context of, for example, organisational culture, training, policies and resources

Practice and organisational learning

This section highlights the key learning points from the review.

This can helpfully be done by laying out key issues or expectations relevant to the case and then commenting on how these were dealt with in the particular case. For example: Practitioners should operate in a clear policy and strategic context and should be supported by guidance, procedures and processes that promote positive practice

• In this situation policy, procedures and guidance relating to the assessment of capacity was not readily accessible to front line workers and was not consistently understood across agencies

For assessment and care planning to be meaningful and robust it needs to be a multi-agency activity, using a range of tools to collect, collate and analyse information, to formulate effective protection plans and to measure change

• In this situation some agencies felt they were excluded from some planning meetings where they felt that they would have been able to contribute to a broader understanding of the adult's circumstances and to the development of protection plans

Effective practice

This section allows for the identification of good practice as evidenced by the review'

Suggested strategies for improving practice and systems

This section contains recommendations for the Adult Protection Committee to consider

Appendices

These will include, if not already within the body of the report

• Review Team membership
• Terms of reference for the review
• Files accessed/relevant documents
• People interviewed (identified anonymously through their professional role or relationship to the adult)