3.5 Responding to concerns
Carers and safeguarding
Circumstances in which a carer (for example, a family member or friend) could be involved in a situation that may require a safeguarding response include:
- A carer may witness or speak up about abuse or neglect.
- A carer may experience intentional or unintentional harm from the adult they are trying to support, or from professionals and organisations they are in contact with.
- A carer may unintentionally or intentionally harm or neglect the adult they support on their own or with others.
Assessment of both the carer and the adult they care for must include consideration of the well-being of both of them. Section 1 of the Care Act includes protection from abuse and neglect as part of the definition of well-being. As such, a needs or carer’s assessment is an important opportunity to explore the individual’s circumstances and consider whether it would be possible to provide information or support that prevents abuse or neglect from occurring. For example, by providing training to the carer about the condition the adult they care for has, or to support them to care more safely. Where training is appropriate the local authority should make arrangements for providing it.
If a carer speaks up about abuse or neglect, it is essential that they are listened to and that where appropriate a safeguarding enquiry is undertaken and other agencies are involved as necessary.
If a carer experiences intentional or unintentional harm from the adult they are
supporting, or if a carer unintentionally or intentionally harms or neglects the adult they support, consideration should be given to:
- Whether, as part of the assessment and support planning process for the carer and / or the adult they care for, support can be provided that removes or mitigates the risk of abuse. For example, the provision of training, information or other support that minimises the stress experienced by the carer.
- Whether the carer needs independent representation or advocacy, or if they may benefit from having such support if they are under great stress or similar.
- Whether other agencies should be involved eg. where a criminal offence is suspected this will include alerting the police, or primary healthcare services may need to be involved in monitoring.
Other key considerations in relation to carers should include:
- Involving the carer in safeguarding enquiries relating to the adult they care for, as appropriate.
- Whether or not joint assessment is appropriate.
- The risk factors that may increase the likelihood of abuse or neglect occurring.
- Whether a change in circumstance changes the risk of abuse or neglect occurring. A change in circumstance should also trigger the review of the care and support plan and / or safeguarding plan.
Further information about these considerations can be found in the ADASS Advice Note ‘Carers and safeguarding adults – working together to improve outcomes’ (April 2011).
Case study 7
Mrs D lives with her husband, B. B has a long-term brain injury which affects his mood, behaviour and his ability to manage close family relationships. This has often led to him shouting and hitting out at his wife, who is also his main informal carer. Mrs D told a professional who was involved in supporting her that she was becoming increasingly frightened by B’s physical and verbal outbursts and at times feared for her personal safety. Other family members were unaware of the extent of the harm. Mrs D was exhausted and considering leaving the situation.
The practitioner, under supervision from her social work manager, invested time in meeting with Mrs D to explore her preferences around managing her safety and how information about the situation would be communicated with the wider family and with B. This presented dilemmas around balancing the local authority’s duty of care towards Mrs D with her wishes to remain in the situation with B. Placing emphasis on the latter inevitably meant that Mrs D would not be entirely free from the risk of harm but allowed the practitioner to explore help and support options which would enable Mrs D to manage and sustain her safety at a level which was acceptable to her.
The practitioner received regular supervision to allow time to reflect on the support being offered and to ensure that it was ‘person-centred’.
The outcome for Mrs D was that she was able to continue to care for B by working in partnership with the local authority. The practitioner offered advice about how to safely access help in an emergency and helped Mrs D to develop strategies to manage her own safety. This included staff building rapport with B, building on his strengths and desire to participate in social activities outside the family home. The effect of this was that some of the trigger points of him being at home with his wife for sustained periods during the day were reduced because he was there less. Mrs D also had a number of pre-existing support avenues, including counselling and a good relationship with her son and her friends.
The situation will be reviewed regularly with Mrs D but for the time being she feels much more able to manage.
Responses to concerns relating to the quality of care and support services
Issues relating to quality will not be dealt with under Section 42 safeguarding enquiries.
Addressing issues relating to the quality of care and support services is primarily the responsibility of the provider service itself, and of agencies responsible for the regulation and commissioning of those services.
Responses to concerns relating to the quality of care and support services will be led and co-ordinated by the service responsible for commissioning the care services, in close partnership with the proprietors or managers of those services, the Care Quality Commission and any other agencies or organisations that need to be involved or informed.
Information relating to quality assurance processes where there are concerns regarding the quality of care and support services must be routinely and proactively shared with local authority adult social care operational teams. This is particularly important where concerns regarding an individual named adult have triggered the local authority’s duty of enquiry under Section 42. The local authority must be involved with these quality assurance processes to ensure communication, decision making and responses are as effective and as well co-ordinated as possible.
Local authority adult social care operational teams have the lead responsibility for responding to concerns regarding individual named adults where enquiries under Section 42 are indicated.
Where a Section 42 enquiry is triggered and there are serious concerns regarding the quality of a care and support service, the Enquiry Manager may decide it is appropriate to approach the Care Quality Commission and the relevant commissioners to request an enquiry is undertaken by them.
In these situations, CQC and commissioners need to respond in line with their responsibilities and advise the local authority of the outcome of their enquiries. The local authority would have to assure itself that the actions taken were satisfactory ie. that the adult has been protected and all actions required have been taken, before its Section 42 duty has been discharged.
Principles to ensure robust co-ordination of responses relating to quality and safeguarding individuals
- Where information indicates a potential or actual concern regarding the quality of a care and support service, the response to this will be led and co-ordinated by agencies with responsibility for commissioning those services, working in partnership with the proprietor or manager of that service and the regulator (Care Quality Commission).
- Effective and proactive information sharing and proportionate responses are essential elements of preventing safeguarding concerns arising by enabling:
- Care and support services to take appropriate action themselves to address any issues as they emerge and to maintain good standards, and safe care and support services.
- Early identification and support for those services to assist them to address any issues.
- All agencies and organisations should have a clear understanding of what information should be shared with which other organisations and agencies, and at what point.
- There should be clear protocols regarding how information about quality issues is routinely and proactively shared. The protocol should include details of agency and team contacts, who is responsible for decision making regarding sharing information, and clear criteria for staff regarding what information should be shared and when, and with which agencies and organisations (this could be described as a ‘virtual quality hub’).
- Where there are quality issues, the co-ordination of multi-agency information sharing, planning meetings and responses is the responsibility of commissioners and contract teams.
- When a commissioner leads the planning, they must involve the operational lead of any Section 42 enquiry.
- There must be clear understanding by all staff regarding information flows and how these may relate to safeguarding concerns.
- Staff should have a clear understanding of the escalation process and protocols where this may be required.
- There should be clear protocols in place to ensure public accountability and transparency regarding quality assurance processes and their effectiveness in preventing abuse and neglect, and protecting adults. This should include clear protocols regarding how any potential conflict of interest in relation to the role of commissioning services will be addressed, and should include how links and accountability to key strategic forums will be maintained including to the Safeguarding Adults Board (SAB), Health and Well-Being Board (HWBB), NHS England Quality Surveillance groups and Serious Incident Panels run by the Clinical Commissioning Groups (CCGs).
Responsibilities in relation to the quality of care and support services
Proprietors and managers of care and support services have overall responsibility for ensuring the quality of the care and support services they run and that these meet required standards of care, and for responding to quality issues effectively as they arise.
Care and support services should routinely share information regarding quality with relevant commissioning services.
Commissioners have the lead responsibility for co-ordinating, analysing and risk assessing quality-related information to provide a proportionate and appropriate response, and liaising and communicating with other agencies and stakeholders as appropriate. This includes ensuring effective communication of relevant information and progress in relation to responses or related actions.
Information relating to concerns regarding the quality of support services
When the local authority, or other organisations, identify or receive information that relates to concerns regarding the quality of services supporting adults, this information should always be shared with the services responsible for monitoring and responding to quality assurance issues. This includes agencies and organisations responsible for commissioning and regulating those services including: Clinical Commissioning Groups (CCGs), local authority and other commissioning services, the Care Quality Commission and operational teams working directly with adults.
Proactive information sharing regarding the quality of care and support services is an important element of prevention, and enables early intervention and support for services where this may be needed.
Who is responsible for co-ordinating and leading responses regarding quality-related concerns?
Where information relates to the quality of a service supporting adults, the manager and proprietor of the service are primarily responsible for responding to and addressing this, to ensure the service they provide safe and meet the required standards.
Commissioners have responsibility for:
- Co-ordinating, analysing and risk assessing quality-related information.
- Co-ordinating multi-agency information sharing and decision making (including lead responsibility for convening information sharing and planning meetings and discussions).
- Determining and co-ordinating the most appropriate single or multi-agency response to the concerns.
- Undertaking and leading co-ordinated multi-agency responses in relation to issues and concerns regarding quality.
Where individual adults have been directly affected by these concerns, the Section 42 enquiry is the responsibility of the local authority. Clear information sharing and close partnership working is required between the safeguarding process and other activity or responses required by other agencies and organisations, including where the local authority has asked another organisation to make an enquiry under its Section 42 duty. This includes those services or agencies responsible for responding to issues relating to the quality of care and support services.
Who will lead and co-ordinate responses relating to different care and support services?
For GPs, dentists and pharmacies This will be NHS England.
For NHS services (other than those above) This will be the local Clinical Commissioning Group (CCG) covering the area where the service is situated.
For health services that are independently run eg. hospices with charitable status Independently run specialist health services that are likely to provide support to adults with specialist health or mental health care needs will need to be determined on a case-by-case basis as agencies that commission these services will vary.
For working age mental health services that are independently run This will ordinarily be the lead commissioning organisation.
For all other independently run care services, other than those commissioned specifically for people of working age with mental health needs This will be the relevant local authority or commissioning service including the contracts team. These services include all independent sector care and support services including care homes (with and without nursing), day services, domiciliary care services, supported living and other support services.
For care and support services run by the local authority or integrated services This will ordinarily be the relevant local authority or commissioners. In these situations there may be a perceived or actual potential conflict of interest, therefore, it is important to ensure there is an appropriate level of transparency, accountability and scrutiny regarding the response by these services. Where it is unclear which local authority commissioners should take responsibility for convening or leading this process, it will be the responsibility of the host local authority of the service provider. Where the service operates in more than one area, it will be the host local authority where the suspected abuse or neglect has taken place.
For services funded through personalised budgets provided to adults to purchase their own care and support The adult or their delegated representative responsible for managing the personal budget is responsible for passing all relevant information regarding the quality of the services they purchase to the commissioners of that service.
Where an adult employs personal assistants or other staff They are responsible for addressing issues relating to quality. Adults or their representatives can seek advice and support regarding this from the local authority. The local authority has a responsibility to provide an appropriate response to the adult and must ensure the adult or their representative is provided with appropriate advice and support.
Where the issues or information meet the three key tests defined in the Care Act, this would be responded to as a safeguarding concern, rather than a quality issue and the local authority’s duty under Section 42 would be triggered in the usual way.
Where it is unclear which agency’s commissioners would have responsibility for leading and co-ordinating a response to information relating to quality, this should not cause a delay in responding to the concerns. In these situations, the local authority commissioners will take responsibility for convening a multi-agency planning process. This will determine which agency is most appropriate to co-ordinate any ongoing multi-agency quality assurance response. Where it is not possible to agree this quickly the local escalation protocol should be used.
The Care Quality Commission (CQC) is responsible for leading responses in relation to regulatory compliance and information relating to the quality of care and support services should always be shared with them. CQC will be an important partner agency regarding appropriate and proportionate responses to information and issues relating to the quality of care and support services. However, commissioning services or contract teams, as outlined above, will be responsible for leading and co-ordinating overall responses eg. for convening multi-agency planning meetings involving all relevant partner organisations.
Safeguarding concerns in regulated settings
When an employer is aware of abuse or neglect in their organisation and an employee is thought to be the cause of risk, then they are under a duty to correct this and protect the adult from harm as soon as possible. The employer must also inform the local authority, CQC and CCG, where the latter is the commissioner (see also: DASM role).
It is important that all partners are clear where responsibility lies where abuse or neglect is carried out by employees or in a regulated setting, such as a care home, hospital, or college. The employing organisation as provider of the service has overall responsibility to address the abuse or neglect. However, social workers or counsellors may need to be involved in order to support the adult to recover.
When an employee is removed or dismissed
If someone is removed from their role providing regulated activity following a safeguarding incident by being either dismissed or redeployed to a non-regulated activity, or they leave their role (resignation or retirement) to avoid a disciplinary hearing, and the employer or volunteer organisation feels they would have dismissed the person based on the information they hold, they have a legal duty to refer to the Disclosure and Barring Service. If an agency or personnel supplier has provided the person, then the legal duty sits with that agency.
In circumstances where the employer does not make a referral then the local authority can make such a referral.
When an employer is taking action regarding abuse or neglect, the local authority is still under a duty to make (or cause to be made) whatever enquiries it thinks necessary to decide what, if any, action needs to be taken, and by whom.
The local authority may be assured by the employer’s response that no further action is required. However, a local authority would have to satisfy itself that an employer’s response has been sufficient to deal with the safeguarding issue and, if not, to undertake an enquiry of its own and any appropriate follow-up action (eg. referral to CQC or professional bodies).
Where it may not be appropriate for the employer to undertake an enquiry
The employer should investigate any concern (and provide any support that the adult may need) unless there is compelling reason why it is inappropriate or unsafe for the organisation to do this. For example, there could be a serious conflict of interest, concerns about ineffective past enquiries, serious, multiple concerns, or a matter that requires investigation by the police.
An example of a conflict of interest where it is better for an external person to undertake the enquiry is the case of a family-run business where organisational abuse is alleged, or where the manager or owner of the service is implicated. The circumstances where an external person would be required should be set out in the local safeguarding procedures. All those carrying out such enquiries should have received appropriate training.
Involvement of partners in responding to safeguarding concerns relating to care and support services
There should be a clear understanding between partners at a local level when other agencies such as the local authority, CQC or CCG need to be notified or involved, and what role they have.
The Association of Directors of Adult Services (ADASS), CQC, Local Government Association (LGA), Association of Commissioners and Police Officers (ACPO) and NHS England have jointly produced a high level guide on these roles and responsibilities.
The focus should be on promoting the well-being of those adults at risk. It may be that additional training or supervision will be the appropriate response, but the impact of this needs to be assessed. Commissioners of care and support services or other professionals should only use safeguarding procedures in a way that reflects the principles above not as a means of intimidating providers or families. Transparency, open-mindedness and timeliness are important features of fair and effective safeguarding enquiries.
CQC and commissioners have alternative means of raising standards, including support for staff training, contract compliance and, in the case of CQC, enforcement powers.
Approach of commissioners
Commissioners should encourage an open culture around safeguarding, working in partnership with providers to ensure the best outcome for the adult. A disciplinary investigation, and potentially a hearing, may result in the employer taking informal or formal measures which may include dismissal and possibly referral to the Disclosure and Barring Service.
Employers who are also providers or commissioners of care and support have both a duty to the adult and a responsibility to take action in relation to an employee when allegations of abuse are made against them.
Reports of abuse, neglect and misconduct should be investigated and evidence collected.
With regard to abuse, neglect and misconduct within a professional relationship, codes of professional conduct and / or employment contracts should be followed and should determine the action that can be taken.
Employers should ensure that robust employment practices, including references that are checked and recent DBS checks, are in place. Their disciplinary procedures must be compatible with their responsibility to protect adults at risk of abuse or neglect.
Referring employees to professional bodies or the Disclosure and Barring Service (DBS)
Where appropriate, employers should report workers to the statutory and other bodies responsible for professional regulation, such as the General Medical Council and the Nursing and Midwifery Council.
If someone is removed from their role providing regulated activity following a safeguarding incident, the service provider has a legal duty to refer to the Disclosure and Barring Service (or if the person has been provided by an agency or personnel supplier, the legal duty sits with them).
The legal duty to refer to the Disclosure and Barring Service also applies where a person leaves their role to avoid a disciplinary hearing following a safeguarding incident, and the employer or volunteer organisation feels they would have dismissed the person based on the information they hold.
The standard of proof for prosecution is ‘beyond reasonable doubt’. The standard of proof for internal disciplinary procedures and for discretionary barring consideration by the Disclosure and Barring Service (DBS) and the Vetting and Barring Board is usually the civil standard of ‘on the balance of probabilities’.
Therefore, when criminal procedures are concluded without action being taken this does not automatically mean that regulatory or disciplinary procedures should cease or not be considered. In any event there is a legal duty to make a referral to DBS if a person is dismissed or removed from their role due to harm to a child or a vulnerable adult.
Referrals to the Disclosure and Barring Service (DBS)
The DBS maintains the register of individuals barred from working with adults and children due to the risk they pose to them.
The local authority has a legal duty, in some circumstances, to refer an individual to DBS where the criteria are met.
The Enquiry Manager will ensure that the referral is made to DBS as part of the adult’s safeguarding plan, and that the person being referred is made aware of this prior to the referral being made.
It is DBS’s decision regarding whether the person should be placed upon the list of those barred from working with adults and / or children. DBS will contact the individual directly to inform them that they have received a referral, and will share all information provided to them with the person, along with any other information they may have received from other sources as part of their decision making process.
Referrals to professional bodies
Where the conduct of an individual registered with a professional body has been the subject of an enquiry, a referral to that professional body should be considered as part of the safeguarding plan
Professional bodies could include: the Health and Care Professions Council (formerly both the General Social Care Council and the Health Professions Council), Nursing and Midwifery Council (NMC) and General Medical Council (GMC).
Where a decision is made that it is appropriate to refer an individual to a professional body following the conclusion of an adult safeguarding enquiry, it is the Enquiry Manager’s responsibility to ensure that the person being referred is advised of this prior to the referral being made.
Employers also have responsibilities in relation to referrals to relevant professional bodies and should follow their own policy and procedures in relation to this.
Professional bodies will follow their own investigation procedures and it is their decision regarding whether any action will be taken in relation to the individual’s professional registration. Professional bodies will contact the individual directly to inform them that they have received a referral and will share all information provided to them with the person, along with any other information they may have received from other sources as part of their decision making process.
Allegations against people in positions of trust (Care and Support Statutory Guidance: 14.120-14.132)
The local authority’s relevant partners, as set out in section 6 (7) of the Care Act, and those providing universal care and support services, should have clear policies in line with those from the safeguarding adults board for dealing with allegations against people who work, in either a paid or unpaid capacity, with adults with care and support needs. Such policies should make a clear distinction between an allegation, a concern about the quality of care or practice or a complaint.
Safeguarding adults boards need to establish and agree a framework and process for how allegations against people working with adults with care and support needs (i.e. those in positions of trust) should be notified and responded to. Whilst the focus of safeguarding adults work is to safeguard one or more identified adults with care and support needs, there are occasions when incidents are reported that do not involve an adult at risk, but indicate, nevertheless, that a risk may be posed to adults at risk by a person in a position of trust.
Where such concerns are raised about someone who works with adults with care and support needs, it will be necessary for the employer (or student body or voluntary organisation) to assess any potential risk to adults with care and support needs who use their services, and, if necessary, to take action to safeguard those adults.
Examples of such concerns could include allegations that relate to a person who works with adults with care and support needs who has:
- behaved in a way that has harmed, or may have harmed an adult or child
- possibly committed a criminal offence against, or related to, an adult or child
- behaved towards an adult or child in a way that indicates they may pose a risk of harm to adults with care and support needs
When a person’s conduct towards an adult may impact on their suitability to work with or continue to work with children, this must be referred to the local authority’s designated officer.
If a local authority is given information about such concerns they should give careful consideration to what information should be shared with employers (or student body or voluntary organisation) to enable risk assessment.
Employers, student bodies and voluntary organisations should have clear procedures in place setting out the process, including timescales, for investigation and what support and advice will be available to individuals against whom allegations have been made. Any allegation against people who work with adults should be reported immediately to a senior manager within the organisation. Employers, student bodies and voluntary organisations should have their own sources of advice (including legal advice) in place for dealing with such concerns.
If an organisation removes an individual (paid worker or unpaid volunteer) from work with an adult with care and support needs (or would have, had the person not left first) because the person poses a risk of harm to adults, the organisation must make a referral to the Disclosure and Barring Service. It is an offence to fail to make a referral without good reason.
Allegations against people who work with adults at risk must not be dealt with in isolation. Any corresponding action necessary to address the welfare of adults with care and support needs should be taken without delay and in a coordinated manner, to prevent the need for further safeguarding in future.
Local authorities should ensure that their safeguarding information and advice services are clear about the responsibilities of employers, student bodies and voluntary organisations, in such cases, and signpost them to their own procedures and legal advice appropriately. Information and advice services should also be equipped to advise on appropriate information sharing and the duty to cooperate under Section 6 of the Care Act.
Local authorities should ensure that there are appropriate arrangements in place to effectively liaise with the police and other agencies to monitor the progress of cases and ensure that they are dealt with as quickly as possible, consistent with a thorough and fair process.
Decisions on sharing information must be justifiable and proportionate, based on the potential or actual harm to adults or children at risk and the rationale for decision-making should always be recorded.
When sharing information about adults, children and young people at risk between agencies it should only be shared:
- where relevant and necessary, not simply all the information held
- with the relevant people who need all or some of the information
- when there is a specific need for the information to be shared at that time.
Where abuse or neglect is carried out by an employee
Employers’ responsibilities It is important that all partners are clear where responsibility lies where abuse or neglect is carried out by employees or in a regulated setting, such as a care home, hospital, or college.
Employers must also ensure all staff keep accurate records, stating the facts, and the known opinions of professionals and others, and differentiating between fact and opinion.
It is vital that the views of the adult are sought and recorded. These should include the outcomes that the adult wants, such as feeling safe at home, access to community facilities, restricted or no contact with certain individuals or pursuing the matter through the criminal justice system.
Local authority’s responsibilities When an employer is taking action regarding abuse or neglect, the local authority is still under a duty to make (or cause to be made) whatever enquiries it thinks necessary to decide what, if any, action needs to be taken, and by whom.
The local authority may be assured by the employer’s response that no further action is required. However, a local authority would have to satisfy itself that an employer’s response has been sufficient to deal with the safeguarding issue and, if not, to undertake an enquiry of its own and any appropriate follow-up action (eg. referral to CQC or professional bodies).
In situations where employers may have a conflict of interest, discussion would be held with the employer to address this.
The local authority must satisfy itself that actions taken are sufficient to protect the adult and where there is concern its duty under Section 42 continues until it is satisfied the adult is protected and all actions needed have been taken.
Criminal offences and safeguarding adults Everyone is entitled to the protection of the law and access to justice. Behaviour which amounts to abuse and neglect, for example physical or sexual assault or rape, psychological abuse or hate crime, wilful neglect, unlawful imprisonment, theft and fraud, and certain forms of discrimination also often constitute criminal offences.
Although the local authority has the lead role in making enquiries, where criminal activity is suspected, then the early involvement of the police is essential.
Case study 8
Miss Y is a young woman with a learning disability with limited support from her family and not engaged with health and social care services.
Miss Y was befriended by an individual who took her to parties where she was given drugs and alcohol, and forced to have sex with different men. Sometimes she would be given money or gifts in return for having sex with the men.
Miss Y disclosed this to a social worker and it was discovered that there were a number of young people and vulnerable adults who were being sexually exploited by multiple perpetrators. Miss Y lacked mental capacity in order to be able to consent to having sex, as well as in relation to her accommodation, finances or personal safety. The perpetrators sought out Miss Y and others because of their vulnerability – whether that was because of their age, disability, mental illness, or their previous history as a victim of abuse.
The process to safeguard Miss Y involved a co-ordinated response between the police, social care, health and voluntary and community sector organisations. This included the police investigating the perpetrators for rape, sexual assault, trafficking and drug offences. The Court of Protection and Deprivation of Liberty Safeguards were also used initially to safeguard Miss Y.
Ensuring adults have fair access to legal remedies through criminal proceedings
For the purpose of court proceedings, a witness is competent if they can understand the questions and respond in a way that the court can understand.
Police have a duty to assist those witnesses who are vulnerable and intimidated. A range of special measures are available to facilitate the gathering and giving of evidence by vulnerable and intimidated witnesses.
Consideration of special measures should occur from the beginning of a police investigation. In particular:
- Immediate referral or consultation with the police will enable the police to establish whether a criminal act has been committed and this will give an opportunity of determining if, and at what stage, the police need to become involved further and undertake a criminal investigation.
- The police have powers to initiate specific protective actions which may apply, such as Domestic Violence Protection Orders (DVPO).
- A higher standard of proof is required in criminal proceedings (‘beyond reasonable doubt’) than in disciplinary or regulatory proceedings (where the test is ‘the balance of probabilities’). Early contact with the police may assist in obtaining and securing evidence and witness statements.
- Early involvement of the police will help ensure that forensic evidence is not lost or contaminated.
- Police officers need to have considerable skill in investigating and interviewing adults with disabilities and communication needs to prevent the adult being interviewed unnecessarily on subsequent occasions. Research has found that sometimes evidence from victims and witnesses with learning disabilities is discounted. This may also be true of others, such as people with dementia. It is crucial that reasonable adjustments are made and appropriate support given so people can get equal access to justice.
- Police investigations should be co-ordinated with health and social care enquiries wherever possible but they are likely to take priority.
- Guidance should include reference to support relating to criminal justice matters which is available locally from such organisations as Victim Support and court preparation schemes.
- Some witnesses will need protection.
- The police may be able to get victim support in place.
Special measures were introduced in the Youth Justice and Criminal Evidence Act 1999 and include a range of measures to support vulnerable or intimidated witnesses to give their best evidence, and to help reduce some of the anxiety when attending court.
These measures include the use of screens around the witness box, the use of live-link or recorded evidence and the use of an intermediary to help witnesses understand the questions they are being asked and to give their answers accurately.
Ensuring the interests and wishes of the adult are considered throughout police investigations
A criminal investigation by the police takes priority over all other enquiries, although a multi-agency approach should be agreed to ensure that the interests and wishes of the adult are considered throughout, even if they do not wish to provide any evidence or support a prosecution.
The welfare of the adult and others, including children, is paramount and requires continued risk assessment to ensure the outcome is in their interests and enhances their well-being.
If the adult has the mental capacity to make an informed decision about their safety and they do not want any action to be taken, this does not preclude the sharing of information with relevant professional colleagues.
This is to enable professionals to assess the risk of harm and to be confident that the adult is not being unduly influenced, coerced or intimidated and is aware of all the options. This will also enable professionals to check the safety and validity of decisions made.
It is good practice to inform the adult that this action is being taken unless doing so would increase the risk of harm.
Case study 9
Mr P has mild learning disabilities. The safeguarding concern was financial and other abuse and neglect by his brother, with whom he lived. His support worker noticed that Mr P had begun to appear agitated and anxious, that he looked increasingly unkempt and that he was often without money; then he suddenly stopped attending his day centre.
When the support worker and the safeguarding officer followed up, Mr P told them that at times he was not allowed out at all by his brother and was confined to his bedroom. He was only allowed to use the bathroom when his brother said he could, and often didn’t get enough to eat. He was also very worried because his bank card no longer worked, and he had no money, so could not buy food for himself.
Mr P consented to move to temporary accommodation, and a case conference was held which he attended with an advocate. At his request a move to a supported living flat was arranged and his belongings were retrieved from his brother’s property. His bank account had been emptied by his brother, so he has made new arrangements for his money. The police are investigating both the financial abuse and the harm Mr P suffered at his brother’s hands. He has begun to talk about his experiences and is gradually regaining his confidence.
Where a crime is suspected and referred to the police, then the police should lead the criminal investigation, with the local authority’s support where appropriate, for example by providing information and assistance.
The local authority has an ongoing duty to promote the well-being of the adult in these circumstances and to ensure that it complies with its Section 42 duty.
Case study 10
Mr A is 24 and has autism and a mild learning disability. He is a very friendly and sociable young man who is prone to waving and talking to most people he comes across, seeing everyone as a potential friend. However, due to his disabilities, he struggles to read the intentions of others and is easily led astray and manipulated.
He lives next door to a pub, where he knows the staff and the regulars. He also lives close to his GP, and is able to access his most frequently visited places. He does, however, like to walk into town to talk to people he meets out and about. On such occasions he has been repeatedly tricked into stealing items from a newsagent by a group of teenagers and given large amounts of money away to strangers he strikes up conversations with.
Due to his previous experiences, Mr A was identified during a needs assessment as being at risk of abuse and neglect. A safeguarding enquiry was triggered. The council found that, although Mr A was not currently experiencing abuse or neglect, he remained highly vulnerable to abuse due to his disabilities.
To assure his safety in the future, a safeguarding plan was agreed between Mr A and a social worker. This focused on developing his social skills and understanding of relationships and boundaries, and the social worker worked with Mr A to consider various support options such as having a buddy or circle of support. The social worker put Mr A in touch with an autism social group which provided sessions on skills for staying safe. As the group was based in town, Mr A’s plan also included a support worker to accompany him. After the first five sessions Mr A was able to attend on his own but continued to meet with his support worker on a monthly basis as part of the risk management strategy set out in his safeguarding plan.