Procedures, practice and information sharing
APC Terms of Reference
The Act allows APCs to regulate their own procedures. To enable APCs to meet their statutory duties, the committees should address those functions set out in section 42 of the Act, namely:
- reviewing adult protection procedure and practice;
- providing information and advice and making proposals;
- improving skills and knowledge; and
- all in the context of improving cooperation and communication between agencies.
These will need to be reflected terms of reference for the APC and any sub committees.
Since the implementation of the Act and the establishment of APCs, a range of other developments in relation to the wider public protection agenda have achieved wider prominence and required multi-agency responses. The duty on councils to inquire into whether someone should be regarded as at risk of harm identifies many people who cannot be so regarded but who are nevertheless regarded as people in distress and who may require supports from a range of agencies. APCs should therefore ensure that local procedures support assessment of need, consideration of other relevant legislation, or alternative services to respond to the individual's needs. This could include practical support, health, social work or social care support provided on a single or multi-agency basis. Preventative options may be considered to avoid an adult's situation escalating to a point where they are or are likely to be at risk of harm.
In some areas, APCs have become the main strategic forum in which the above matters can be discussed. This reflects the interconnections between many aspects of public protection, and APCs may prompt wider public protection topics for Chief Officer Groups to consider.
Local Terms of Reference may therefore go beyond the statutory requirements of the Act, or allow APCs to address some matters not fully falling within the terms of the Act, if so approved by the APC.
APCs are required to keep under review the procedures and practices of the public bodies which relate to the safeguarding of adults at risk, and in particular any such procedures and practices which involve co-operation between the council and other public bodies. They will therefore have to ensure that procedures and practices as they relate to the named public bodies are both multi-agency and multi-disciplinary. These should address
- referral and initial response;
- inquiry, including an investigatory stage if required;
- assessment and risk assessment;
- adult protection conferences and protection planning;
- risk and protection planning monitoring; and
- risk and protection plan review.
Inquiries under the Act can range from the relatively straightforward to highly complex and therefore require different levels of engagement. However, local procedures should identify indicative timescales for completion of identified tasks. Review of the procedures of the named public bodies should ensure that each agency's ASP procedures align and are consistent on an inter-agency basis.
Single agency procedures
Good practice will dictate that APCs should also monitor practice and quality relating to the protection of adults across agencies. Many agencies will have their own internal procedures, audit and monitoring systems. Where relevant to the responsibilities of the APC such procedures and systems should be advised to the committee.
We all have a responsibility, individually and collectively, to protect vulnerable people in our communities. This cuts across all aspects of private life and professional business. Supporting individuals at risk of harm is best done through collaboration and with a sense of community responsibility.
Why do we need to share adult protection information?
Organisations need to share safeguarding information with the right people at the right time to:
- prevent death or serious harm
- coordinate effective and efficient responses
- enable early interventions to prevent the escalation of risk
- prevent abuse and harm that may increase the need for care and support
- maintain and improve good practice in safeguarding adults
- reveal patterns of abuse that were previously undetected and that could identify others at risk of abuse
- identify low-level concerns that may reveal people at risk of abuse
- help people to access the right kind of support to reduce risk and promote wellbeing
- help identify people who may pose a risk to others and, where possible, work to reduce offending behaviour
- reduce organisational risk and protect reputation.
APCs will want to consider the information sharing dynamic between the statutory agencies and other agencies or organisations, to identify any gaps in information sharing related to safeguarding adults at risk and to promote, wherever possible, the adoption of information sharing practices and co-operative working as are required of statutory agencies.
Existing legislation, including the UK General Data Protection Regulation - UK GDPR and the Data Protection Act 2018 does not prevent sharing and/or exchanging relevant information where there is belief or concern about the protection of adults at risk. Wherever possible, the adult who may be at risk should be informed of the sharing of the information and the reasons why. The information sharing must be necessary (i.e. proportionate and targeted) for the purpose of carrying out the task.
Detailed guidance around the required aspects of information sharing is available in the main ASP Code of Practice.
Many partnerships have circulated letters, signed by the Chief Officers, to staff of the main relevant public bodies locally (i.e. the Council, the Health Board and Police Scotland) affirming the position stated above, and advising their staff that their own agency will support them if they have shared personal information in these circumstances using their professional judgement. All partnerships should consider circulating such letters to their staff, confirming this position and the expectations around information sharing, as outlined in the Code of Practice (link above).
APCs may choose to publish minutes from their meetings, taking care to ensure that sensitive or confidential information is redacted prior to publication.
Giving information or advice and making proposals
The main forum for addressing the matters outlined in this section will be at the regular meetings of the Chief Officers for the council area. These are generally held quarterly with a standing item for report(s) on Adult Protection activity and issues. This is the opportunity for matters identified by APCs to be brought to the attention of Chief Officers.
The Biennial Reports and any routine interim overview reports will also be programmed into Chief Officer Group agendas and provide another forum for these matters.
The Act requires APCs to give information or advice, or make proposals to its statutory members on the safeguarding of adults at risk present in the council area(s). APCs do not have executive authority but in order to meet this requirement they will need expertise in, and understanding of, service standards as they apply to adult support and protection. Detailed awareness of local professional practice and performance management enables APCs to measure performance and development, and identify areas for improvement.
The information, advice and proposals duties will be undertaken based on the regular collection and analysis of activity and performance data, 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 additional research would be helpful. Over time, APCs will be able to consider practice and performance trends from the information available.
The Scottish Government has established a data set that councils are required to report on annually. As national data collection evolves to contribute to national understanding of ASP activity, learning and improvement, the frequency of national data collection may increase. In addition to this national data collection, APCs will have identified other activity information that they wish to collect on a local level. In keeping with its function to keep under review the procedures and practices of the public bodies named in 42(3),
APCs may wish to consider how ASP-related data from these public bodies contributes to the APC's overall dataset and understanding of local ASP activity.
Data collated by the APC will be shared by APCs with the statutory bodies, enabling them to use data to contribute to their own agency's improvement and practice development. These data sets will provide valuable information determining trends and priorities for attention, as well as for the allocation of resources.
APCs have a strategic and monitoring function rather than an operational role and therefore routine case review under the auspices of the committee would not be appropriate. Planned audit programmes will, however, be an invaluable source of information on service standards and areas for improvement that can result in advice and proposals for change to the statutory bodies. Additionally, learning from case reviews, both internally and from elsewhere nationally, is an important way in which APCs can identify areas for improvement and increase the skills and knowledge of staff.
Audit and quality assurance activity
A regular programme of multi-agency audit, self-evaluation and review should be part of the routine work of APCs, directly influencing strategic development and practice improvement. Included in this should be an awareness of any internal audit work that may be undertaken on a single agency basis. Multi-agency audits are most productive when staff from across agencies are engaged in auditing their own and other agency files. This requires good preparation and inter-agency agreement to the approach. Views of individuals with experience of adult support and protection processes should be considered when undertaking audit activity.
Adult Protection Committees should also consider regular audits of the extent to which adults are enabled to participate fully in adult protection activity. Any audit of adult participation should seek to ensure contributions from adults themselves, including their own comments on the process and outcomes.
While not referenced in the Act, it is now accepted practice across all APCs that learning reviews are commissioned by APCs across Scotland. The purpose of such reviews is to gain a multi-agency understanding of the circumstances of a particular case and to identify what can be learnt in order to best inform future policy, practice and procedure.
In May 2022, the Scottish Government published National Guidance for Adult Support and Protection Committees Undertaking Learning Reviews.
This guidance document provides an update to the previously published Adult protection significant case reviews: interim framework (November 2019).
The Learning Review guidance, now much aligned to the equivalent guidance for learning reviews undertaken by Child Protection Committees, places the responsibility for commissioning and overseeing such reviews with Adult Protection Committees, on behalf of the Chief Officer's Group. It confirms that APCs are responsible for agreeing recommendations within case reviews and for overseeing any improvement plans that may follow. These matters should be reported to the local Chief Officer Group (or equivalent) for approval and, once approved, reports of case reviews that meet the criteria laid out in the guidance should be submitted to the Care Inspectorate (including any case review or reflective learning review that referred to by a different name but meets the criteria for a learning review). As of 1 October 2020 the Care Inspectorate is the central repository for all learning reviews. They will support practice development through disseminating the learning from these.
Recommendations arising out of learning reviews can have implications for all of the statutory members of the APC (and for other agencies, including care providers). In this regard, through conducting their own case reviews, reflecting on the learning from other reviews, and identifying any recommendations for implementation at a local level, APCs are carrying out their function to give advice or make proposals to public bodies.
Situations may arise for learning reviews, particularly for 16 and 17 year old people, where there are legitimate interests and engagement from services for both children and adults. In such circumstances there should be discussions between the Child and Adult Protection Committees to determine which is the most appropriate to lead on a Learning Review, with agreement reached as to how each of the committees will be involved and updated on progress of the Review. This will require consideration on a case by case basis, and the involvement of the Chief Social Work Officer may be helpful in these deliberations.
Large Scale Investigations
A Large Scale Investigation (LSI) may be required where there is reason to believe that adults who are residents of a care home, supported accommodation, an NHS hospital or other facility, or who receive services in their own home may be at risk of harm due to another resident, a member of staff, some failing or deficit in the management regime, or in the environment of the establishment or service. In such circumstances, there may be concern that multiple adults are at risk of harm, arising from the same alleged source of harm.
The Act makes no reference to LSIs, but these have become increasingly prevalent across Scotland since the implementation of the Act. Many
partnerships have their own procedures, sometimes across a number of partnerships (e.g. within one Health Board area). LSIs frequently involve other agencies including the Care Inspectorate, the NHS and Police Scotland. However, there are no nationally agreed definitions of what warrants an LSI, nor guidance for conducting LSIs, nor guidance for governance arrangements locally. The updated Code of Practice provides some broad guidance for consideration by partnerships in developing their LSI procedures.
Senior managers in partnerships are responsible for initiating and overseeing LSIs. They should keep Adult Protection Committees regularly appraised of the progress of any LSIs underway, and provide the Committee with a final report once the LSI is concluded. This will ensure that any necessary actions arising from the LSI relating to the duties of Adult Protection Committees can be noted and necessary responses actioned. The outcome of LSIs should be brought to Chief Officer Groups for their information.
Additional operational guidance related to LSIs can be found in the main Code of Practice.
Whilst not directly referenced in the Act it is now an accepted part of the role of APCs to ensure that there are strategies in place to ensure that they maintain an overview of levels of knowledge and confidence in adult protection systems within their area, including within partner agencies and in public awareness of adult support and protection in the wider community.
Improving skills and knowledge
APCs have a duty to make or assist with 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 strategy will therefore be required, recognising the different roles and responsibilities of staff and office holders in the public bodies. Given the essential inter agency importance of adult support and protection work consideration should also be given to including the role of other statutory, voluntary and private organisations.
The elements of a local training strategy should address:
- 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, what action to take, including who to report their concerns to, and how they fit into a protection plan;
- the opportunity for staff working in any sector to reach an understanding of the importance of working with people in a way that supports them and promotes their wellbeing and health in the context of the Act;
- staff working in any sector who will be playing a major part in communications, assessments (including about risk, capacity and consent), recording events, decision-making on actions to be taken, and have a major role in the implementation of protection plans, including legal processes;
- staff managing services who will be supervising others in contact with service users, who will be monitoring performance at a local or central level and who may be involved in decision-making in individual cases and chairing adult protection conferences and reviews;
- staff working in the statutory and legal sectors who will be taking a lead role in legal proceedings in relation to adult protection work; and
- staff in other areas of work including advocates in local organisations, members of APCs, regulatory staff within the Care Inspectorate, council clerical, administrative staff or other staff who will act as initial contacts for referrals or minute takers in adult protection case conferences, guidance staff in secondary schools for those pupils aged 16 to 18 years and lecturing and tutoring staff within local education institutions.
The need to support and protect adults at risk extends to adults within managed and registered care services. Where harm is happening or suspected in these situations, the Care Inspectorate in the required format has a responsibility with its regulatory functions through inspection, complaints and enforcement. As with other aspects of practice, APCs will want to ensure a proper understanding of roles and responsibilities between the Care Inspectorate and local agencies through further development of existing Memoranda of Understanding.
The duties and powers contained in the Act relate to adults in all settings who are being harmed 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. As with registered care services, APCs will want to consider how adult protection work relates to NHS services and how to ensure the Act's implementation in relation to these services.
It is equally important for people who use services to understand their rights and the supports available to them. APCs may also want to develop a broader communication strategy, encompassing general awareness raising and appropriate training for service users, carers and members of the public. They may also wish to consider asking service users to act as co-workers in delivering such programmes.
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