Multi Agency Guidance - CVS Falkirk

A duty to consider the importance of theearly provision of advocacy or othersupportive services. The establishment of multi-disciplinaryAdult Protection Committees. A range of Protection Orders as defined inthe Act, namely – Assessment Orders,Removal Orders and Banning Orders.Legal Principles of 2007 ActThe principles in relation to any interventionin the life of an adult, taken under the AdultSupport and Protection (Scotland) Act 2007,are set out as follows:A public body or office holder must besatisfied that any intervention will provide: Benefit to the adult which could notreasonably be provided withoutintervening in the adults affairs and is, of the range of options likely to fulfilthe object of the intervention, the leastrestrictive to the adult’s freedom.Public bodies or office holders must also haveregard to the following: The adult’s wishes and feelings (past andpresent).adult (who is not at risk of harm) wouldbe treated in a comparable situation. The adult’s abilities, background andcharacteristics.The principles must be taken into account atall stages of any intervention and emphasisethe importance of striking a balance betweenan adult's right to freedom of choice and therisk of harm to that person. Any interventionmust be reasonable and proportionate.It is important to note that the adult at risk(and/or their representatives) are not boundby the principles of the Act.However any representatives (such as aPower of Attorney or Guardian under the2000 Act and a Named Person under the 2003Act) may be bound by the principles of thatlegislation to act or have regard to certainlegal principles.Definitions within the ActCouncilSection 53 of the Act states a Council is asconstituted under the Local Government(Scotland) Act 1994. References to a Councilin relation to any person known or believed tobe an adult at risk mean the Council for thearea where the person is currently located. The importance of the adult participatingas fully as possible in the performance ofthe function and providing the adult withsuch information and support as isnecessary to enable the adult toparticipate.In practice, this means that the Council wherethe adult is currently located is responsible forconducting inquiries, investigations andmaking applications for protection orders. Foradults placed in care settings funded byanother Council area (a cross-boundaryplacement), the host authority is responsiblefor undertaking inquiries into adults at risk.It is expected that where another Council hasa locus, for example, for care managementand payment of costs, then this Council willhave a role in any activity under the 2007 Act. The importance of ensuring the adult isnot treated less favourably than anotherFor further details see Appendix One – ForthValley Cross-Boundary Protocol. Any views of the adult’s nearest relative,primary carer, guardian or attorney andany other person who has an interest inthe adults well-being or property.7

Who is an “Adult at Risk”?Guidance on the Term “Unable”The 2007 Act refers throughout to adult. Interms of Section 53 of the Act an adult meansa person aged 16 years or over who is an“adult at risk”. Section 3(1) defines an adultat risk as adults who:-The first element of the three-point criteriarelates to whether the adult is “unable” tosafeguard their own well-being, property,rights and other interests. Are unable to safeguard their ownwell-being, property, rights or otherinterests; Are at risk of harm and; Because they are affected by disability,mental disorder, illness or physical ormental infirmity, are more vulnerable tobeing harmed than adults who are not soaffected.Additional Considerations onDefinition of Adult at RiskThe presence of a particular condition doesnot automatically mean an adult is an adult atrisk. Someone could have a disability but beable to safeguard their well-being etc.It is important to stress that all threeelements of this definition must be met orthat there are grounds for believing all threeelements may be met for an adult to be anadult at risk and for interventions to takeplace under the 2007 Act. It is the whole ofan adult's particular circumstances which cancombine to make them more vulnerable toharm than others.Also there should not normally be a “once andfor all” categorisation of people as an adult atrisk. An individual’s vulnerabilities, medicalconditions and abilities can fluctuate andchange over time.“Unable” is not defined in the Act orguidance, but is defined in the Oxford EnglishDictionary as “Lacking the skill, means oropportunity to do something”.A distinction should therefore be drawnbetween an adult who lacks these skills and isunable to safeguard themselves, and one whois deemed to have the skill, means oropportunity to keep themselves safe, butchooses not to do so.An inability to safeguard oneself is not thesame as an adult not having capacity. An adultmay be considered unwilling rather thanunable to safeguard themselves and so maynot be considered an adult at risk.When Drug/Alcohol Misuse is anIssueIn terms of the definition of an “adult at risk”the 2014 Code of Practice states thatvulnerability or a lack of ability to safeguard,which is due to temporary problematicalcohol or drug use, would not by itself resultin an individual being considered an “adult atrisk”.Adults have the right to make choices anddecisions about their lives, including the useof alcohol and drugs, even if that means theychoose to remain in situations or indulge inbehaviour which others considerinappropriate.Without any additional vulnerability, such asan illness or disability, adult protectionintervention would not normally beappropriate. Young people aged 16-18 can beparticularly easily influenced and legislationplaces limits on children not in place for adultssuch as access to alcohol.8

The Code of Practice further states theongoing problematic use of drugs or alcoholmay take place alongside (and on occasionscontribute to) a physical or mental illness,mental disorder or a condition such as alcoholrelated brain damage. If this is the case anadult may be considered an “adult at risk”. Itmust be stressed, however, that it is theco-existing illness, disability or frailty, whichwould trigger adult protection considerations,rather than the substance use itself.What About Young PeopleTransitioning from Childhood toAdulthood?The Code of Practice states the need to “payparticular attention” to the needs and risksyoung people in transition from youth toadulthood can experience. It stresses thateach such situation needs to be consideredindividually.Further that there is a need to identify suchyoung people “at the earliest stage possible”and for robust and effective systems to be inplace to share information betweenagencies/workers and ensure a transfer ofresponsibilities.What About Self-directed Supportand Adults Need for Support andProtection?The introduction of the 2013 Act aims to giveadults, children and families more choice andcontrol over their social care arrangementsand involve them more in decisions abouttheir support. The Code of Practice statessuch legislation could, in some instances,increase risks to some people but can alsohelp a person develop their ability to protectthemselves.How Does the Issue of MentalCapacity Affect the DecisionWhether an Adult is an Adult atRisk?The law in relation to adults (i.e. anyone overthe age of 16), makes a distinction betweenthose who are capable of managing theiraffairs and those who are not.The assumption in law is that all adults havethe capacity to make decisions about theirown affairs until or unless they arerecognised, in law, as being incapable.Consent, capacity and risk will always becentral to any assessment.It is important to be aware than adult mayhave capacity to make decisions about anarea of harm in their life but still be regardedas unable to protect themselves from thatharm and therefore be an “adult at risk”.Where a situation of harm is suspected staffmust consider, as early as possible in theinvestigative process, whether or not theadult has capacity in that area of their life.Also in any situations where a ProtectionOrder might be beneficial and necessary anydecisions must consider the issues of theadult’s capacity to consent to such an Orderand also give consideration of the issue ofUndue Pressure (for details on ProtectionOrders and the concept of Undue Pressuresee Chapter Seven of these procedures).9

Definition of HarmWhere and when does Harm Occur?Section 53 of the Act states harm includes allharmful conduct and, in particular includes:-In short harm can happen anywhereincluding: Conduct which causes physical harm. At home within the family. Conduct which causes psychological harm(for example by causing fear, alarm ordistress). Whilst in a hospital or a hospice. Unlawful conduct which appropriates oradversely affects property, rights orinterests (for example theft, fraud,embezzlement or extortion). Whilst staying in a care home orsupported or sheltered accommodation. Whilst at a day centre or an educationalplace. At the adult’s place of work or training. Conduct which causes self-harm. In a public place.Further Section 3(2) states an adult is at riskof harm if: Another person's conduct is causing (or islikely to cause) the adult to be harmed, or The adult is engaging (or is likely toengage) in conduct which causes (or islikely to cause) self-harm.The Code of Practice adds that this list is notexhaustive and no category of harm isexcluded simply because it is not listed(above). Behaviours that constitute harm toothers can also include neglect (andself-neglect), emotional, sexual, institutional,human rights or a combination of any ofthese.In terms of signs and indicators of possibleharm refer to the document - Guidance forthe Independent Care Sector in ReportingAdult Support and Protection concerns inForth Valley (Appendix Two).Harm can be perpetrated by people the adultat risk already knows, where a trustingrelationship of unequal power may exist. Theperpetrator themselves may be anotherservice user or adult at risk who may haveexperienced harm themselves. Harm can alsobe perpetrated by someone unknown or notwell known to the adult at risk.Harm can also be opportunistic anddependent on issues of low self-esteem, lowsocial status or when people are isolated fromcontact with others. It can be caused withdeliberate intent or arise from acts ofomission but whatever the cause of reasonthe imperative to reduce harm is clear.For further details and guidance see AppendixTwo - Guidance for the Independent CareSector in Reporting ASP concerns in ForthValley.10

Who is a Council Officer Under the2007 Act?The investigating officer has been given,within the 2007 Act, the title of CouncilOfficer.The definition of a Council Officer within the2007 Act at Section 53(1) is that a CouncilOfficer is an individual appointed by a Councilunder Section 64 of the Local Government(Scotland) Act 1973. Section 53(1) alsoenables ministers to restrict the type ofindividual who may be authorised by a councilto perform council officer’s functions.The exact definition of a Council Officer isdefined in Sections 3 and 4 of SSI regulation2008 No 306 2007 Act (Restrictions on theAuthorisation of Council Officers, Order2008) and is summarised as being someonewho: Is registered in the part of the SSSCregister maintained in respect of socialworkers or is the subject of an equivalentregistration; Is registered in the part of the SSSCregister maintained in respect of socialservice workers; Is registered as an occupational therapistin the register maintained under article5(1) (establishment and maintenance ofregister) of the Health Professions Order2001(5); orAdult Protection CommitteeThe 2007 Act creates an obligation onCouncils to establish multi agency AdultProtection Committees (APCs). The functionsof the APCs include: To keep under review the procedures andpractices of the public bodies; To give information or advice to anypublic body in relation to the safeguardingof adults at risk within a Council area, and To make, or assist in the making of,arrangements for improving the skills andknowledge of employees of the publicbodies.In performing these functions, APC’s musthave regard to the promotion and support ofco-operation between each of the publicbodies. The public bodies involved are therelevant council(s), the relevant Health Board,the Chief Constable of Police Scotland and anyother public body as may be specified byScottish Ministers.APC membership must includerepresentatives of the relevant localauthorities, NHS Board and Police Force. TheMental Welfare Commission, Social Care &Social Work Improvement Scotland (SCSWIS),Healthcare Improvement Scotland and theOffice of the Public Guardian also have theright to attend and must be informed of AdultProtection Committee Meetings. Is a nurse; and (b) The person has at least 12 monthspost qualifying experience of identifying,assessing and managing adults at risk.In the three councils in the Forth Valley areaCouncil Officers are qualified (and registered)Social Workers, Occupational Therapists andNurses (employed by the council e.g. as a CareManager) who are suitably experienced andtrained.11

Public Protection ForumChild Protection CommitteeThe Guidance for Adult ProtectionCommittees advises they will require to begiven the authority by local agencies to beable to carry out their functions effectively.The guidance also indicates that lines ofaccountability between the APCs and localCouncils, NHS Boards and Police will requireto be identified.There may be some areas of cross-overbetween child protection and adult protectioninformation when dealing with families whichhave both children and adults at risk.Although they may be investigated separately,a link between the two would require to bemaintained.It is therefore expected that direct lines ofcommunication between APCs and local ChiefOfficers’ Groups will be established in eacharea.Within Forth Valley the two APC’s reportdirectly to the Forth Valley Public ProtectionForum. This forum comprises of seniorrepresentation from each of the five statutoryagencies.A further area of overlap may exist where aperson is aged 16 or 17 years and could beclassed as both a young person in need ofsupport through Children’s services and anadult at risk. The duties outlined in the 2007Act would require to be reflected in practice.The Guidance for APCs highlights theimportance of procedural and practice linkswhich should be made between adultprotection, child protection and the publicprotection role of criminal justice services.The guidance indicates that monitoring andadvising on these links will be a function forAPCs.12

Chapter Two - ReferralsThis section describes the steps to be takenwhen any professional person, working forany agency identifies (or is concerned) anadult may be an adult at risk of harm.Information about adult protection concernsmay come to agencies from different sourcesand this guidance should be followed in allsituations.The Council, as lead agency, is responsible forthe overall co-ordination of adult protectionconcerns.When an adult at risk is identified the personmaking the referral must report that concern,by phone call, to the Social Work Service onthe same day the concern arises. Further thereferrer must confirm, in writing (by using theAP1 referral form) within one working day.Reporting EmergenciesThis chapter provides guidance on making aplanned referral to the Council.However some situations can arise when aperson must act to protect an adult withoutthe benefit of consulting with a manager.When it appears that a person is imminentlyat risk then the following immediate actionsmay be necessary: If a person is in immediate danger orneeds urgent medical treatment then a999 call should be made to request urgentassistance or advice from the appropriateemergency services. Callers should follow this with a call tolocal Social Work Services to advise themof the situation or, outside of office hours,make a referral to the Emergency SocialWork Services Team. In an urgent situation, if it is suspectedthat a crime has been committed then theadult should be encouraged to report thisto the Police and support offered to themto do this. A check (with the Police) thatthe report has been made will benecessary. If the adult will not report thematter to the Police, this should still bereported on their behalf. The Policeadvised that it relates to someone whomay be an adult at risk in terms of the2007 Act and if the adult has consented tothe report being made or not consented.What if the Situation is Not anEmergency but a Crime May HaveBeen CommittedIn the case of physical or sexual harm,immediate referral to the Police is essential.This is to ensure that the person receivesappropriate medical attention and that vitalforensic evidence is not lost.Following a sexual assault try to discouragethe victim from using the toilet, washing,drinking or laundering clothes and bedding.Clothes should not be changed if there is theslightest possibility that the clothing was wornat the time of the assault. The scene of theassault will also need to be preserved forevidence and no-one should be allowed in. Ifthis is where the victim is, nothing should betouched or moved whilst waiting for thePolice to attend.Follow up with a referral to Social WorkServices and advise them that the Police havebeen contacted.The Police will log the referral and takeappropriate action to ensure the victim issafe. The Police will make enquires. The Policeshould ensure that all adults at risk of harmincidents have been referred to Social WorkServices. Police and Social Work Servicesshould continue to liaise throughout to ensureappropriate support to the adult.13

Duty to Report ConcernsVoluntary and Private SectorsThe 2007 Act states where a named publicbody or office-holder knows or believes that aperson is an adult at risk and action needs tobe taken in order to protect that person fromharm, then that public body or office-holdermust report the facts and circumstances ofthe case to the Council.Voluntary and Private sector agencies in theForth Valley area are expected to report adultprotection concerns within the sametimescale as public bodies i.e. phone call onthe same working day and written referral(the AP1 form) submitted within one workingday.Staff should also be clear who they have aduty to report to within their ownorganisations.The bodies and office holders listed in Section5 of the 2007 Act are: The Mental Welfare Commission forScotland; Care Inspectorate; The Office to the Public Guardian; All Councils; Chief Constable of Police Scotland; The relevant Health Board, and; Healthcare Improvement Scotland.Any other public body or office-holder as theScottish Ministers may by order specify.(Scottish Ministers have not specified anyother bodies at the time of writing – March2018)While the 2007 Act does not make it a legalrequirement for other

On electronic versions if you click the legislation name it will link to the law. 1. Social Work (Scotland) Act 1968 2. Mental Health (Scotland) Act 2015 3. National Health Service and Community Care Act 1990 4. Community Care and Health (Scotland) Act 2002 5. Regulation of Care (Scotland) Act 2001 6. Public Services Reform (Scotland) Act 2010 7.