ADULT HEALTH AND CARE PROCEDURE 01/17
Section 42 Safeguarding Duties
VERSION NUMBER 2
Effective date / 31/01/2017
Category / Adults’ Health and Care General
Summary / This document outlines the safeguarding process and practice guidance to be followed in line with duties under Section 42 of the Care Act 2014.
Approved by / Care Governance Board
Date Approved
Procedures cancelled or amended
Author / Hampshire Safeguarding and Governance Unit
Sponsor / Jo Lappin, Head of Safeguarding and Governance
Contact
Signed
Designation
Date
Version control change record
Date / Version Reviewed / Author / Reason for change / Approved by
PURPOSE
This procedure outlines the process for Hampshire Adults’ Health and Care staff to follow in relation to their duties under Section 42 of the Care Act 2014. It should be read in conjunction with the over-arching Hampshire Multi Agency Policy, Guidance and Toolkit 2015 (4LSAB) and the Large Scale Enquiry Policy. All safeguarding activities must be undertaken in a person centred way, ensuring that the adult is as fully and meaningfully engaged in the process as is possible, and that their views and desired outcomes are taken into account as a part of decision making.
SCOPE
The policy applies to adult(s) at risk who are individuals known to or appear to be in need of care and support. This includes adults who fund their own care and support.
REFERENCES
  • The Care Act 2014
  • Care and Support Statutory Guidance 2014
  • Hampshire Multi Agency Policy, Guidance and Toolkit 2015
  • Hampshire Adult Services Large Scale Enquiry policy
  • PAN Hampshire and Isle of Wight Framework on Safeguarding in Commissioned Services (February 2015)
AUTHORITY TO VARY
Head of Safeguarding and Governance, Hampshire Adults’ Health and Care
CONTENTS
The Principles That Guide Safeguarding Practice
Making Safeguarding Personal
The Spectrum Of Safeguarding Responses
Large Scale Enquiries (LSE)
Summary Chart – Hampshire Process and Practice Guidance
APPENDICES
Appendix 1 Guide to Safeguarding Adults Process
Appendix 2 Guide to Safeguarding Adults Process Easy Read
Appendix 3 Meeting Request Form
Appendix 4 Information Gathering Form, including MSP outcomes
Appendix 5Standard Letter to send to Agency undertaking Enquiry
Appendix 6Section 42 Enquiry Report Template
Appendix 7Section 42 Enquiry Terms of Reference Template
Appendix 8Safeguarding Recovery Plan
DUTIES/RESPONSIBILITIES/ROLES
This procedure outlines key roles for Hampshire Adults’ Health and Care staff involved in undertaking, supporting and managing safeguarding activities.
INTRODUCTION
Safeguarding protects an adult’s right to live in safety, free from abuse and neglect. It supports people and organisations to work together to prevent and stop both the risks and experience of abuse or neglect, while at the same time making sure that the adult’s wellbeing is promoted including, where appropriate, having regard to their views, wishes, feelings and beliefs in deciding on any action.
THE PRINCIPLES THAT GUIDE SAFEGUARDING PRACTICE
The following principles are enshrined in all safeguarding activity.
Empowerment / Presumption of person led decisions and informed consent
Prevention / Its better to take action before harm occurs
Proportionality / Proportionate and least intrusive response appropriate to risks
Protection / Support and representation for those in greatest need
Partnerships / Local solutions through services working with their communities
Accountability / Accountability and transparency in delivering Safeguarding
The principles of the ‘Making Safeguarding Personal’ (MSP) approach underpin all our safeguarding duties under Section 42 of the Care Act. Safeguarding practice has to be effective from the perspective of the person being safeguarded. Good practice will involve social care practitioners having conversations with adults who may be at risk of harm about how we might respond in safeguarding situations in a way that enhances their involvement, choice and control as well as improving quality of life, wellbeing and safety. Staff working alongside those adults will need to have a clear understanding of the outcomes people want from safeguarding.
The ethos of ‘Making Safeguarding Personal’ is a shift from a process supported by conversations to a series of conversations supported by a process. This procedure will provide staff with the templates and guidance to achieve high quality Section 42 duties in line with the principles of the Care Act.
THE SPECTRUM OF SAFEGUARDING RESPONSES
The Local Authority must make enquiries, or cause others to do so, if it believes an adult is experiencing, or is at risk of, abuse or neglect. However the Care Act encourages a more creative and flexible approach to safeguarding, and considering what is the most appropriate and proportionate response to protect the adult from harm. For example where there are care management, case management or Care Programme Approach frameworks already in place, it may be very appropriate to use these as the vehicle for safeguarding the adult. Whichever approach is used should establish whether any action needs to be taken to prevent or stop abuse or neglect, and if so, by whom. There are a range of meeting types that can be used as appropriate including Best Interest, Quality Outcomes Contract Monitoring (for lower level provider concerns), Safeguarding Large Scale Enquiry and Safeguarding Section 42 meetings.
Duties under Section 42 offer a whole system approach to safeguarding activity designed to provide a wide spectrum of support necessary to ensure that safeguarding responses are proportionate, least intrusive and:
  • Are based on the needs and wishes of the person
  • Enable prevention and early intervention
  • Recognise that safeguarding work is carried out at different levels often day to day as part of an organisation’s core business
  • Foster on a ‘whole system’ approach
  • Provide a gateway to mainstream community safety and crime prevention measures
It should be noted that Safeguarding is not a substitute for:
  • Professional responsibilities to provide or support others to provide safe and high quality care and support
  • Commissioners regularly assuring themselves of the safety and effectiveness of commissioned services
  • The Care Quality Commission (CQC) ensuring that regulated providers comply with the fundamental standards of care or by taking action enforcement action
  • The core duties of the police to prevent and detect crime and protect life and property
  • Robust risk management and risk assessment
Spectrum of safeguarding responses

LARGE SCALE ENQUIRIES (LSE)
Please refer to the LSE procedure for full details. A large scale enquiry into a provider service can be carried out alongside individual adult safeguarding enquiry.The adult(s) at risk should remain at the centre of any safeguarding activity. Making Safeguarding Personal, (MSP) is about ensuring that the adult starts and remains at the heart of all safeguarding enquiries. This can also be applied to activities relating to a large scale enquiry. However the wishes of an individual adult at risk need to be balanced alongside wider considerations such as the level of risk or risk to others.
SUMMARY CHART OF THE HAMPSHIRE SAFEGUARDING DUTIES UNDER SECTION 42 OF THE CARE ACT
The statutory safeguarding duties are engaged when a person with care and support needs (whether or not they are ordinarily resident in the local authority area or whether the local authority is meeting any of those needs) and they are experiencing, or are at risk of abuse or neglect and, as a result of those needs, is unable to protect him or herself.
The following chart outlines the key elements of the process and practice guidance that should be followed. The recording guidance is also covered within the chart.

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Hampshire Adults’ Health and Care,Safeguarding Duties under Section 42 of the Care Act 2014

At a glance process, practice guidance and recording chart

The key principles: Empowerment, Prevention, Proportionality, Protection, Partnership and Accountability.

  • The adult should always be involved from the beginning of the enquiry unless there are exceptional circumstances that would increase the risk of abuse. If the adult has ‘substantial difficulty’ in being involved, and where there is no-one appropriate to support them, the LA must arrange for an independent advocate to represent them (statutory guidance 14.43).
  • Timescales - the Care Act requires that responses remain person centred rather than being process driven. The ‘scope of an enquiry, who leads it, its nature, and how long it takes will depend on the particular circumstances’ (statutory guidance 14.77).The Hampshire Multi-Agency Procedure adopts the principle of no delay which requires the safeguarding response to be made ‘in a timely fashion commensurate with the level of presenting risk’ (policy section 2).

Safeguarding Duties apply to an adult who:
  • has needs for care and support (whether or not the local authority is meeting any of those needs) and;
  • is experiencing, or at risk of, abuse or neglect; and
  • as a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect.
If unsure proceed as if duties apply and information gather
Discretionary Duties can apply if all 3 criteria are not met
Address any immediate safety issues and proceed to: / AIS Recording
In contact as ‘Adult Safeguarding Concern’ - Include type of abuse, location, perpetrator and relationship to victim if known)
Add additional detail on case notes as needed headed Adult Safeguarding.
Initial contact with adult and information screening
  • If appropriate and safe talk with adult, consider mental capacity, arrange advocacy if required
  • Gain the adult’s views on what has happened to them and agree immediate protection plan if required Ensure process is explained, record the conversation with the adult including their desired outcomes to inform next steps
  • Consider initial role of provider agency – what information or initial enquiries can they be required to make
  • Consider signposting for support or Family Group Conference if appropriate.
  • Identify if further information gathering is required and how to gather this

Decision Point - review information and make management decision
  1. S42 safeguarding duties (or discretionary duties) do not apply. Signpost and advise as necessary
  1. S42 safeguarding duties (or discretionary duties) apply and have been fulfilled - chosen outcomes and actions needed in relation to the concern have been taken.
  1. S 42 safeguarding duties (or discretionary duties) apply and a sound plan is in place to deliver chosen outcomes and actions needed in relation to the concern. Safeguarding S 42 enquiries (multi agency) meetings not required. Continue with plan and set date for review.
  1. S 42 safeguarding duties (or discretionary duties) apply and are complex, have not been able to be resolved or are high risk. .Progress to Safeguarding S42 enquiry (multi agency) meetings
/ -Decision Maker
  1. Record defensible decision as Adult Safeguarding case note
  2. Record defensible decision as Adult Safeguarding case note
  1. Incident to be recorded on module and progressed as indicated
  1. Incident to be recorded on module and progressed as indicated

The Local Authority’s enquiry duty under Section 42 continues until it decides what action is necessary to protect the adult, by whom and that the action has been taken (statutory guidance 14:84).

Risk considerations / Decision Maker / Practice Guidance
The Act encourages us to be flexible, pause and review, and to exit or escalate when needed. / Recording
-Consider adult’s wishes
-Risks identified but actions taken as needed / Close to section 42 duties / -Feedback to adult and referrer
-Signpost to support as needed / -Add outcome to contact.
-Update desired outcomes as needed.
- record defensible decision in case notes titled Adult Safeguarding
-Consider adult’s wishes, may need more information gathering
-Risks present but can be safely managed using robust CPA, case management etc. / Gather info & manage risk using on-going Section 42 duties / -Confirm case holder (HCC or other commissioner/agency)
-Person centred protection plan agreed with adult
- Set terms of reference for any further information gathering/enquiries required.
-Liaise with other agencies and agree actions, timescales as required
-Arrange advocate if needed / Decision Maker - close once risk of harm & user outcomes resolved OR remain open to S42 and escalate to ‘added value’ meetings if appropriate. (see below) / -If closed feedback to adult and referrer
-Were desired outcomes met?
-Signpost as needed / - Workflow contact to SGAO
- SGAO record as a Safeguarding Adult (SA) incident if duties apply and link to contact
- record defensible decision in case notes titled Adult Safeguarding
-Complete MSP extra questions.
-Identify plan to monitor risk in Strategy Discussion in Safeguarding Event.
- Monitor and review
-Consider adult’s wishes
-Complex allegations need further enquiries with Terms of Reference
-High impact risks needing multi agency meetings / Section 42 Enquiry Duty / -Confirm case holder (HCC or other commissioner/agency)
-Arrange advocate if needed, consider venue to suit adult,
-Start chronology
-Invite adult/rep/advocate
-(By week 1) hold safeguarding discussion or meeting
-Person centred protection plan agreed with adult
-If risks reduced, consider closure to S42 & give prompt feedback to adult. If risk remains, meeting to set ToR enquiry / -Safeguarding enquiry proceeds
- Ensure adult is kept informed
-Revisit desired outcomes with adult
-Mental capacity assessment if needed / - Decision Maker to analyse enquiry reports (by week 5) - risks resolved and adult’s outcomes met?
-If yes close to S42 enquiry, provide prompt feedback to adult and referrer.
- Safeguarding plan to support adult’s recovery & future safety / -If risk remains safeguarding review meeting invite adult/rep/advocateto review protection plan and consider further actions required.
-Final review and user feedback / -Send meeting request form
-Record discussions and meeting in SA module and case notes titled Adult Safeguarding.
- Continue to record in Safeguarding Event until duties fulfilled
- Complete extra questions & outcomes feedback
- Following AIS guidance on case closure

In all cases meetings can happen at any point if this would bring ‘added value’ to the enquiries.

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IMPLEMENTATION CONSIDERATIONS

Training has been developed and will be rolled out across the Department.

MONITORING COMPLIANCE

Compliance will be monitored by the Safeguarding and Governance Team using routine monitoring approaches at the end of the first year of implementation. The ASPIRE scorecard performance reports will also be used to support front line teams and outcomes will be reported to DMT.

DOCUMENT REVIEW

This policy will need to be reviewed in 12 months. All existing policies and procedural documents must be reviewed at least every 3years from the date of last issue.The Policy Sponsor and Author will be responsible for agreeing the review date for this policy

EQUALITY IMPACT ASSESSMENTS (EIA)

The online EIA will be submitted after approval at the Governance Board and before implementation.

POLICY IMPLEMENTATION PLAN

The procedure will be implemented using the usual vehicles of departmental training, team brief and regular safeguarding surgeries led by the Safeguarding and Governance Consultants with front line teams.

APPENDICES

Appendix 1 Guide to Safeguarding Adults Process
Appendix 2 Guide to Safeguarding Adults Process Easy Read
Appendix 3 Meeting Request Form
Appendix 4 Information Gathering Form including Making Safeguarding Personal Outcomes
Appendix 5Standard Letter to send to Agency undertaking Enquiry
Appendix 6 Section 42 Enquiry Report Template
Appendix 7Section 42 Enquiry Terms of Reference Template
Appendix 8Safeguarding Recovery Plan

APPENDIX 1

APPENDIX 2

APPENDIX 3

CONFIDENTIAL

SAFEGUARDING ADULTS, QUALITY OUTCOME CONTRACT MONITORING AND BEST INTEREST MEETING REQUEST FORM

To avoid unnecessary delay in arranging your meeting, please note…

  • All information must be complete and correct, including full contact details for invitees or the form will be returned to you
  • When completed, please attach this form to an email and send to your LOCAL Safeguarding Admin team.
  • SSSTSEASSafeguarding team South East
  • SSSTNEASSafeguarding team North East
  • SSSTWESTSafeguarding team West
  • SSHQADSASafeguarding Administrator

Adult reference number
Name of adult
Service provider
Responsible team
Enquiry type
Please indicate which option / Individual Section 42
Provider Quality Outcomes and Contract Monitoring
Provider Section 42
Large Scale Enquiry
Best Interest
Type of meeting
Please indicate which option / Planning
Review
Category of abuse
Summary of concern
Date and time of meeting
Meeting Location
Confirm room booking has been made and address details including postcode
Name of confirmed Chair
Is the adult/provider aware of the concern?
Time of adult/provider
(or representative’s) arrival
(if different from start time)
Invitees / Name and full contact details
(email, telephone and postal address) / ‘X’ if essential attendee
Adult
Family members
Adult’s advocate / other representative
Provider representative
Allocated worker/Care Manager
Police
(RMS number must be provided) / RMS:
Other (for example CQC ()
NB: CQC must be invited if investigation relates to a service provider) / Use ‘tab’ key for more rows
Hampshire County Council
Use ‘tab’ key for more rows
Health
NB: Practice Manager must be copied in when a GP is invited
Please use the box below for further information, Specifically consider service user needs, e.g. special requirements, multi-part meeting, any risks, accessibility arrangements etc.
Meeting requested by
Date request sent

APPENDIX 4

CONFIDENTIAL

INFORMATION GATHERING
(FOR USE IN ALL SAFEGUARDING ACTIVITY INCLUDING QUALITY OUTCOMES AND CONTRACT MONITORING (QOCM) AND BEST INTEREST)

This form is to be used to clarify what action needs to be taken in response to all contacts or concerns raised regarding individuals or provider services. The information gathered on this form will inform discussion with the Team Manager and decision to progress to Section 42 Enquiry.

Date and time of incident
Name of adult/provider
Reference number
Date of birth
Responsible team
Involvements

1Background information and details of contact or concern. (ensure you record what the concern is, how and when we were notified, initial desired outcomes, thorough details of issues raised)

2Capacity Assessment

Does the adult have capacity to understand this process?
YES / ACTION – complete Outcomes section
No / ACTION – complete Best Interests section

3Adult views and desired outcomes (if applicable)