Protecting adults at risk in London: Good practice resource

Cross-borough protocol: The safeguarding pathway

Safeguarding adult alert/referral

  • The role of the host authorityOpen

    Once a safeguarding concern/alert/referral has been raised it is the host authority’s responsibility to lead the initial response in consultation with the funding/placing authority. However, in some circumstances it may be necessary for the host authority to take immediate action to protect the adult at risk (e.g. contact the police or other emergency services).

    If – as part of the initial protection plan – the adult is moved to a place of safety, funding responsibilities remain with the funding/placing authority.

    This initial protection plan will be reviewed throughout the investigation process.

    In consultation with the funding/placing authority the host authority will seek, where appropriate, medical assessment of any injuries/concerns.

    The host authority will coordinate the safeguarding process. This will include gathering information regarding the incident, undertaking background checks of the provider and/or individuals involved, and promptly notifying the funding/placing authority and other relevant agencies.

    The host authority will allocate a SAM who will have overall responsibility for coordinating the safeguarding adults investigation.

  • The role of the funding/placing authorityOpen

    The funding/placing authority has responsibility to make sure that liaison takes place with the adult at risk/family/carer/advocate as agreed during the safeguarding adults process.

    This will include:

    • informing and updating them regarding the safeguarding adults process
    • informing and updating them regarding the progress of the investigation
    • ensuring that the adult at risk’s views, wishes and feelings are represented and taken into account within the safeguarding adults investigation process
    • actively involving the adult at risk and family members where appropriate, and taking responsibility for ensuring the views of the family are represented in any best interests decisions
    • identifying a safeguarding liaison person who will take responsibility for ensuring actions are fed back to the host authority during the investigation process.

    When the funding/placing authority is notified of a safeguarding adults alert/referral it will retain the overall responsibility to ensure that the placement can or will continue to meet the individual’s needs within a safe environment.

    If this is not possible, the funding/placing authority must find an alternative placement. The funding/placing authority must also ensure that the current provider has made adequate provision for the immediate protection and meeting of the individual’s care needs until the move occurs, liaising with the host authority where appropriate. The funding/placing authority will provide all relevant information to the host authority’s SAM and contribute to initial decisions about the need for further investigation.

Strategy discussion/meetings

  • The role of the host authorityOpen

    It is the host authority’s responsibility to arrange the initial strategy meeting/discussion and ensure all appropriate funding/placing authorities contribute.

    The host SAM will chair the strategy meeting and try to ensure that all agencies are working together effectively. They will invite the funding/placing authority to attend, and wherever practicable, the funding/placing authority should also attend.

    The strategy meeting/discussion will agree roles and responsibilities for undertaking the investigation, including those tasks assigned to the funding/placing authority. Coordination of the investigation, in line with the London multi-agency safeguarding procedures and local guidance, remains with the host authority. Coordination includes, ensuring the investigation report and agreed contributions of other agencies to the investigation process are completed, management oversight, compliance with procedures and compliance with good standards of safeguarding practice.

    The host authority’s involvement in the actual tasks of investigation – as opposed to their coordination role, and how this is balanced with the role of the placing/funding authority in terms of tasks in the investigation process – has to be resolved at the strategy meeting/discussion. It needs to be concluded in the best interests of not only the individual who may have been abused, but any wider risks to other adults in the location. For example, an allegation concerning an individual who is the responsibility of another authority – but which has clear implications of risks to others in a care home – would see the host authority assuming a major role, especially if other residents are placed/funded by them. An individual incident that has no implications for others would see the placing/funding authority assume a major role. This is because they would normally have an established relationship with the adult at risk and therefore would be the most appropriate body to interview that individual.

    In their coordinating role, the host authority also needs to ensure that all parties agree on the practicalities of completing the investigation report at the strategy meeting. For example, whether the host authority collates contributions into the body of one report or whether contributing agencies submit separate reports. Whatever the agreed method, the host authority is responsible for ensuring the investigation report is of a good standard for making informed protection decisions.

    The strategy meeting/discussion will set out a clear inter-authority communications plan, which will include communication with the adult at risk, family and advocates, including IMCAs where appropriate. This communication plan should be reviewed regularly.

    The strategy meeting will agree how other funding/placing authorities (e.g. of individuals not identified as alleged victims) will be informed of the concerns raised.

  • The role of the funding/placing authorityOpen

    The funding/placing authority will attend, engage and participate in all strategy meetings and discussions. As this authority has overall responsibility for the adult at risk, it may be the most appropriate body to undertake or be involved in the investigative interview of the individual.

    The strategy meeting will decide if there are specific investigative tasks or activities in relation to the person placed or funded, and the funding/placing authority will carry these out.

    If Mental Capacity Act assessments are needed as part of the safeguarding investigation, these will also remain the responsibility of the funding/placing authority.

Following completion of the investigation

  • The role of the host authorityOpen

    When the safeguarding adults investigation is completed – and prior to the case conference – it is the host authority’s responsibility to arrange a planning meeting or discussion with the funding/placing authority. The purpose of this meeting is to:

    • share the findings of the investigation
    • agree the content of the investigator’s report(s)
    • agree recommendations to the safeguarding adults case conference
    • agree the process of communication with the adult at risk/family/carers/advocates regarding the outcome of the investigation and content of the case conference report(s)
    • agree if and how attendance at the case conference of the adult at risk/family/carers/advocates will be managed
    • discuss the content of the protection plan, where appropriate.
  • The role of the funding/placing authorityOpen

    When the safeguarding adults investigation is completed the funding/placing authority will attend/contribute to the planning meeting/discussion arranged by the host authority. At this meeting the funding/placing authority will:

    • agree the content of the investigator’s report
    • agree the recommendations to be made to case conference
    • lead on communication with the adult at risk/family/carers/advocates regarding the outcome of the investigation and the content of the case conference report(s)
    • agree if and how attendance at the case conference by the adult at risk/family/carers/advocates will be managed
    • where appropriate, lead on the discussion of a protection plan to be agreed at the case conference
    • propose how the protection plan will be reviewed by the funding/placing authority.

Safeguarding adults case conference

  • The role of the host authorityOpen

    The host authority will arrange the case conference with the funding/placing authority, which will contribute to it and attend.

    The case conference will be chaired by a SAM from the host authority, who will meet with or telephone the adult at risk/family/carers/advocates before the conference to introduce themselves and explain their role.

  • The role of the funding/placing authorityOpen

    The funding/placing authority will attend the case conference. It will ensure that family members are invited and, where appropriate or required, support families with any travel arrangements.

    Where the adult at risk/family/carers/advocates cannot attend the case conference the funding/placing authority will obtain their views so they can be represented. It will then feed back to all parties the outcome of the conference.

    The funding/placing authority will submit its proposed protection plan for the adult at risk in writing to the case conference for endorsement, if it is not already included in the investigator’s report completed for the conference.

Safeguarding adults protection plan

  • The role of the host authorityOpen

    The host authority is responsible for keeping the funding/placing authority informed of progress made on any tasks it is allocated, or additional concerns.

    It is also the host authority’s responsibility to keep the CQC informed of progress and outcomes.

    The host authority will ensure that the service provider makes referrals to the ISA or other professional body as appropriate. It will also liaise with the funding/placing authority to ensure that the protection plan is reviewed within the timescale set at the case conference.

  • The role of the funding/placing authorityOpen

    Ongoing protection planning is the responsibility of the funding/placing authority, which will convene and chair a protection plan review if required. The funding/placing authority will also identify a core group of key individuals to implement the protection plan. The funding/placing authority will notify the host authority of the outcome of the review agreed at the case conference.