When do the procedures apply/not apply?
When does the procedure apply?
The procedure should be applied if a situation arises indicating there are serious safeguarding concerns about a service provided for adults. This procedure should also be used in conjunction with children’s services when it is identified that there is an indication of a serious safeguarding risk to service provision by providers of both adults and children’s services.
The DSP Adult Safeguarding Practice Tool [PDF Document] should be used to identify the level of seriousness of an individual concern and assist Adult Social Care services and other agencies in determining the most appropriate level of response to initial safeguarding adult concerns. It is important that the level of response to a safeguarding concern is kept under constant review and is proportionate, as additional information becomes available.
Indicators that trigger consideration for invoking this procedure include:
- Serious concerns are raised following individual or multiple safeguarding enquiries/investigations
- Contract compliance visits identify systemic issues within a care setting and there are significant concerns about the quality of care provided and the ability of the provider to improve the service
- CQC inspections result in placing services into special measures, issuing warning notices or inadequate ratings for safety
- Multi-agency concerns about systemic problems within a service or organisation
- A series of safeguarding concerns are made about the same provider indicating that the provider is not operating a safe service
- A safeguarding enquiry raises serious concerns about a service or organisation
- A number of safeguarding allegations are made against more than one member of staff
- A cluster of concerns are received about similar issues e.g. pressure ulcers; individuals not properly nourished or hydrated
- It is alleged that a number of perpetrators are suspected of abusing or neglecting adults, experiencing, or at risk of abuse and neglect
- A whistle-blower makes serious allegations about the management or regime of a service
- An individual case of alleged abuse is serious or complex e.g. the alleged perpetrator holds a position of authority within a care setting/organisation
- An individual case of alleged abuse meets the criteria for a Safeguarding Adults Review.
By invoking this procedure there can be a detrimental effect on the operating business of care providers. There is an expectation that commissioners will have procedures in place to actively monitor concerns at an early stage and ensure measures are taken to support the care provider to improve thereby minimising the escalation of risk and the need to apply this procedure.
The distinction between abuse and poor care practice is difficult to define and therefore any conclusion reached should be evidence based using the outcome of investigation/s and advice/information received from appropriate professionals and regulatory bodies.
When does the Procedure not apply?
Most safeguarding enquiries/investigations within provider services will not lead to a wider investigation under this procedure, although most cases could have implications for a larger group of adults than the individual at risk initially identified.
This procedure does not replace the normal contract compliance and quality assurance processes, although it may run alongside these.
The Care Act 2014 introduces responsibilities in relation to provider failure and other service interruptions. The Act imposes clear legal responsibilities on local authorities where a care provider fails. The Act also makes it clear that local authorities have a temporary duty to ensure that the needs of adults continue to be met if their care provider becomes unable to carry on providing care because of business failure, no matter what type of care they are receiving. This is regardless of whether the adult pays for their care themselves, the local authority pays for it, or whether it is funded in any other way. In these circumstances, the local authority must take steps to ensure that the adult does not experience a gap in the care they receive as a result of the provider failing. Therefore, there is a clear difference between business failures as defined by the Care Act 2014 and when a provider comes under this process due to the safety in the delivery of care and services from a safeguarding perspective. It should be noted that there may be instances in which a provider fails under the definition of provider failure within the Care Act and there are concerns relating to safeguarding and the quality of care. In these circumstances, agreement on which area will lead is to be negotiated, e.g. safeguarding or commissioning.